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Mr. Edward Vaizey (Wantage) (Con): Will the Minister give way?
Ms Winterton: I have taken a number of interventions, and I am afraid that if the hon. Gentleman's Front-Bench colleagues are complaining about the time that I have taken, I can take no more interventions.
We have introduced many new community services, but as I have said, it is also important to ensure that there is high-quality in-patient care, which is why we committed £130 million of capital investment to that. However, it is true that some people are still waiting too long for treatment and some are having difficulty in accessing the sort of treatment that they would choose for themselves, particularly psychological therapies such as cognitive therapy. For people with signs of mild depression or anxiety, psychological therapies can extend choice, reduce waiting times and help to keep them in work or support them in getting back into work earlier.
Linda Gilroy (Plymouth, Sutton) (Lab/Co-op): Earlier in my hon. Friend's speech she referred to 40 per cent. of the people on incapacity benefit, and I welcome her point about early intervention. Would she give encouragement to staff at my local Jobcentre Plus whom I met yesterday, who are keen to work with GPs and offer them support in that important area?
Ms Winterton: I am pleased to hear that my hon. Friend's visit to Jobcentre Plus had such productive results because, as the pathways to work project has shown, extra help and advice can make a real difference to getting people back to work.
We are committed to widening access to psychological therapies as a supplement to medication, as recommended by the National Institute for Health and Clinical Excellence, and we clearly set that out in the White Paper that we published last week. We will be looking to provide faster access to more specialised services for those who need them, and more choice for people in the kind of care that they receive, and in who
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provides that care. We will set up two demonstration sites that will focus on people of working age with mild to moderate health problems and aim to help them stay in, or return to, work. We also know that people with mental health problems suffer from serious inequalities in physical health, which is why our White Paper on public health set out a series of ways to tackle those inequalities.
The hon. Member for South Cambridgeshire spoke of access to, and experience of, mental health care for black and minority ethnic communities. For decades the problem went unrecognised and unchallenged. We have begun to change that. A year ago, following the report on the death of David Bennett, we published "Delivering Race Equality in Mental Health Care", a comprehensive five-year action plan to put right what was clearly unacceptable. One of the first steps along the way was last year's census of mental health in-patients. It confirmed the problems that we knew existed for people from black and minority ethnic communities. That is why, alongside the census, we have chosen 17 places throughout the country that are leading the implementation of the five-year action plan.
Mr. Steen: Will the hon. Lady give way?
Ms Winterton: There is no such thing, I am sure, especially in the hon. Gentleman's case.
The hon. Member for South Cambridgeshire talked about the draft Mental Health Bill. We will introduce the Bill when parliamentary time allows. It is vital that we modernise mental health law and bring it into line with human rights legislation. Where compulsory treatment is necessary, we must reach a quality and level of service that gives people the treatment that they need and minimises the need for further periods of compulsion. These are not easy issues to deal with, but we are determined to do so.
Improving the mental well-being of individuals and our wider community, and tackling the stigma and discrimination suffered by those with mental health problems, will not be achieved simply by modernising mental health legislation and reforming mental health services. We need an approach that stretches across Government, which is why in 2004 we published the social exclusion unit report, which sets out a series of steps that need to be taken by the Government at all levels. For example, we need to examine access to housing, employment and a range of local services, which many of us take for granted. That is also why we published the health, work and well-being strategy at the end of last year, which looks at how to help people stay in work, and also how to help people back to work. That was part of the overall direction of travel set out in our recent Green Paper on welfare reform.
Let us recall the situation 10 years ago, and how mental health services looked then. We had thin community services, modern treatments were rationed, and the use of the Mental Health Act 1983 was rising year on year because of pressure on acute care. There was no clear policy direction, and there was no action in
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critical areas, such as the care of people from ethnic minorities. Anybody who was working in the service 10 years ago, and who looks at it again now, knows how much has changed. It is no longer a Cinderella service. It is a vital and thriving part of a modern national health service.
Our record on mental health is one of unprecedented progress and achievement. What I have described today is a serious, radical and long-term programme of change and modernisation. That is the future of mental health care under this Government. I urge hon. Members to vote against the Opposition motion and for our amendment.
Steve Webb (Northavon) (LD): I begin by reinforcing the Minister's words of praise for those in the national health service and the voluntary sector who work with people who have mental health problems. I am sure that all hon. Members who meet those who work on the front line admire their commitment and dedication. Many of them are doing jobs that I would find very difficult.
I welcome the fact that we are having the debate, and the selection of subject matter. It is a neglected topic of debate in the Chamber. In the eight months that I have been spokesman for our party, this is the first opportunity that I have had to debate it in the Chamber. I hope that the choice of subject represents a genuine change and a genuine commitment by the Conservatives to the NHS, and that it bears no relation to the recent letter from the Conservative leader to his colleagues, urging them to get active on the NHS and shed the party's negative image on the health service. I hope it is a lasting commitment.
Dr. Julian Lewis: The hon. Gentleman will recall that he entered the House in the same year as I did1997and that having come second in the ballot for private Member's Bills, I introduced a Bill on mental health services. I am grateful for the strong support that I received from the Liberal Democrats at that time, so the hon. Gentleman should be aware that there is a tradition among Conservatives of being concerned about these matters. I did not hear the Minister say anything about the abolition of mixed sex wards, which was an interest that the hon. Gentleman and I had in common. Is he aware of what progress has been made, and will he put that to the Minister?
Steve Webb: I am happy to pay tribute to the hon. Gentleman's personal record on these matters. Mixed sex wards are an important issue. There was a Labour manifesto commitment to get rid of them entirely, yet one in four patients across the national health service, including all forms of health care, still experience a mixed sex ward at some point during an in-patient stay, which is a long way from the rhetoric. I hope that in winding up, the Minister will be able to address the up-to-date position on that.
Mr. Steen: Will the hon. Gentleman give way?
Not at the moment. Those on the Conservative Front Bench are keen that as many as possible of the hon. Gentleman's colleagues get in.
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When one reads Government amendments in debates such as this, one often wonders what world they are describing. We have just heard the Minister describe an unprecedented programme of achievement and progress. As an antidote, so to speak, to the Government rhetoric on the health service, the Liberal Democrats some months ago established a website designed to give members of the public around the country an opportunity to feed in both good and bad experiences of the health service. We have received many comments through libdemnhswatch.com about what is happening in mental health services around Britain. I shall refer to one or two examples, which put a different perspective on the Government amendment and the Government's spin.
One submission that came in a couple of months before Christmas was from a gentleman in the Bristol area, who wrote:
"I would comment on the provision of mental health care as little or none. I suffered from depression and was given tablets and a list of private practitioners who I could contactthis was not the GP's fault, and indeed she did all she could to listen, and take care of me to the extent that the NHS provides for."'
One of the themes of my remarks is that GPs are in the front line of mental health provision. The GPs to whom I talk say that perhaps three quarters or four fifths of mental health provision is done by GPs, many of whom are not trained to any great degree to do it, and that perhaps a third of GPs' time is taken up with mental health issues. There is a real gapI do not mean this pejorativelybetween the relatively superficial level of support and care that an untrained generalist can provide and the most acute in-patient care. There are some very big gaps in that spectrum and, as a result, problems arise from the lack of preventive work being done in the community.
The person who contacted us talked about raising £400 scraped together out of a student loan, which comes back to the point about young people with mental health problems. He says:
"I spent 8 months on some very pricy drugs, at around £150£250 cost to the NHS every 2 weeks . . . Had I been treated with therapy,"
which is mentioned in the Conservative motion
If the NHS can deal with people effectively up front, it will potentially save money.
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