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Ms Winterton: My hon. Friend makes an important point. We need to make better use of the voluntary sector, because in many senses it has been able to reach out to people who may not have been gaining access to services. We need to maximise the use of those skills. Last year, I launched some guidance with Victor Adebowale. It was all about how trusts needed to look closely at their relationship with the voluntary sector, and how they could operate services jointly. That approach fits in with our recent White Paper, and it applies particularly to mental health.

James Duddridge (Rochford and Southend, East) (Con): Will the Minister give way?

Ms Winterton: I need to make some progress.

In total, more than 700 new multi-disciplinary teams are now working for mental health in the community. The NHS plan proposed expanding by 150 the capacity for secure places for people with severe personality disorders. We now have 205 of those new places. The NHS plan set a target of 500 community gateway staff—experienced mental health professionals—to improve patients' access to specialised services. We now have more than 1,500 of them, compared with our target of 500. The NHS plan also set a target of 50 early intervention teams for younger people who experience the first onset of psychosis, and we now have more than 100 of those teams.

I should like to take this opportunity to pay tribute to the many thousands of people who work in mental health services. Too often they go unrecognised, but without them we would not have been able to make real improvements in services for some of the most vulnerable and often excluded members of our society.

David Taylor: The Government amendment spells out some of the progress that has been made, and several trends are encouraging. Does the Minister agree that among young people, levels of self-harm and indeed
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suicide, especially among young men between the ages of 15 and 24, are distressingly high? Is she planning any initiatives to target young people, especially those in higher and further education who are living away from home? There is still a problem to be resolved.

Ms Winterton: My hon. Friend is right, because obviously, any suicide is a suicide too many. However, the success of the suicide strategy has meant that the numbers have dropped considerably and we are leaders in the European Union. There are a range of things that we can do to support more people in the community, but I will come to that later.

Several hon. Members rose—

Ms Winterton: I will give way to the hon. Member for North Shropshire (Mr. Paterson) and my hon. Friend the Member for Stoke-on-Trent, South (Mr. Flello), and then I will move on.

Mr. Owen Paterson (North Shropshire) (Con): I thank the Minister for giving way—she is being very generous. When I went to see her in July, I mentioned Shelton hospital, which is set to be the last working Victorian asylum unless it is rebuilt, which is the plan of Shropshire County primary care trust—the lead organisation—Telford and Wrekin PCT and Powys local heath board. Five years ago, the cost of the project would have been between £40 million and £50 million, but it has now grown to £85 million. The strategic health authority has put the project on hold because of the problems in Shropshire's health economy. If the delays carry on, there will be a bill of £400,000 each month. When does the Minister think that the last Victorian asylum will be replaced, thus saving taxpayers the £400,000 that is lost for every month that the delay continues?

Ms Winterton: The hon. Gentleman knows very well that it is for his local trust and strategic health authority to examine that matter closely. It is important to move services into the community as much as possible. Obviously we must preserve some in-patient care, but the more we can provide modern reformed services in the community, the better. We have announced extra investment to improve in-patient facilities, but that matter is for local discussion.

Mr. Robert Flello (Stoke-on-Trent, South) (Lab): Much of the debate has been focused on adult mental health services and services for younger adults, especially in relation to suicide. Will my hon. Friend say a few words about mental heath services for children and adolescents, and the fantastic work that is done in that area?

Ms Winterton: My hon. Friend is right to say that excellent work is done in that area, too. There have been shortages in some of the professions involved in mental health services for children and young adults, so we are trying to address that problem. It is important to ensure that there is co-ordination between mental health services for younger adults and those for older ones. Too often people get caught in one area or another, which causes enormous difficulties. We have taken steps
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to ensure that there is better co-ordination, and our tsar, Professor Louis Appleby, has taken an overall strategic view on that.

Liz Blackman (Erewash) (Lab): Will my hon. Friend give way—at a suitable point?

Ms Winterton: At a suitable point, I will.

In 1999–2000, the NHS and social services spent £4.74 billion on mental health services. In 2003–04, the figure had risen to more than £6 billion, which was an increase of more than 27 per cent, or a £1.2 billion increase in real terms. As was shown in a recent independent survey of planned mental health investment, the increase has continued in subsequent years. There has been an increase every year since we published the national service framework. Such unprecedented investment has allowed us to make significant improvements to mental health services.

Liz Blackman: My hon. Friend will agree that early identification is paramount; often, people who are developing mental illness first come into contact with generalists rather than specialists. What conversations has she had with professional bodies representing different medical practitioners about making mental health a core component of their training?

Ms Winterton: We have been looking closely at specialist GPs, who can make an early diagnosis. We also want to facilitate the professional exchange of information, so that practitioners can look out for those early symptoms, and they can be followed up by intervention teams if people are obviously deteriorating.

I want to address some of the points that the hon. Member for South Cambridgeshire made about what he called cuts to mental health services, and it will be helpful if I set out some of the facts. In response to concerns expressed in the past few months, we recently asked for information from all 28 strategic health authorities. Twenty of them reported no reductions to planned expenditure on mental health services this year; the remaining eight reported that there would be reductions in planned expenditure affecting 11 trusts—11 trusts, of 84 trusts in England. Those trusts had planned to spend £894 million this year, and they are reducing their planned expenditure by a total of £16.5 million—2 per cent. of the total.

To summarise, 11 of 84 trusts are making expenditure reductions that amount to £16.5 million out of a total expenditure on mental health of more than £6 billion—0.3 per cent. of the total. Of course, in the light of the extra investment that we have made, we would prefer it if there were no planned reduction in expenditure. However, I hope that I can assure right hon. and hon. Members that strategic health authorities are working with those trusts to minimise any impact on patient services.

Anne Milton (Guildford) (Con): Does the Minister agree that despite the figures that she has quoted, many people working in mental health services, particularly in the community, still feel that they are part of a
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Cinderella service, that there are huge gaps in their opportunity to deliver services, and that those gaps are being filled week after week, day after day, by those working in the voluntary sector?

Ms Winterton: I believe that there has been a turnaround in the delivery of mental health services in this country, owing to the extra investment and the changed ways of working. It is important that we, as Members of Parliament, recognise those changes. There have in the past been difficulties in recruiting people to mental health services because they are constantly told that those are Cinderella services that are on their way out. We must recognise that mental health care is an exciting place to work, with new, modernised, reformed services that have received extra investment. We must recognise, too, that three out of four patients who use mental health services are very satisfied with the service that they receive.

I turn now to our plans for mental health services, as set out in our amendment.

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