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That, for the purposes of any Act resulting from the Children and Adoption Bill [Lords], it is expedient to authorise the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable out of money so provided under any other Act.[Mr. Heppell.]
Mr. Nick Gibb (Bognor Regis and Littlehampton) (Con): I have pleasure in presenting a petition signed by more than 400 residents of Middleton and Felpham in my constituency. It expresses opposition to the proposal to install a 14 m high telephone mast in the middle of the village. The planning authority, Arundel district council, refused planning permission, following which Vodafone appealed to the Deputy Prime Minister. I am grateful to Mandy Brown and all those who have worked to collect the signatures and who have organised protests against the mast.
Declares that there is a proposal for a Vodafone base station site at the Southern Water compound, Middleton Road, Felpham, Bognor Regis, West Sussex. The petitioners strongly object to the positioning of a Vodafone mast close to Bishop Tufnell Schools, the Health Centre and at the heart of a residential area.
Mr. Edward Vaizey (Wantage) (Con): I am extremely grateful for the opportunity this evening to debate the important subject of child psychiatry; indeed, to continue the theme of this afternoon and talk about services for children. I begin by making a few general remarks about mental health in this country. It is a matter of common agreement that mental health services are often seen as the Cinderella of the health service. It always seems to me that mental health services are last in the queue for funding and first in line for cuts. It is particularly difficult because in recent years we have grown to understand more and more about mental health issues and problems. In this country, for example, it is now known that up to 10 per cent. of young people between the ages of five and 16 experience significant mental health problems such as depression, self-harm, obsessional disorder, anorexia or anxiety. What is less well known perhaps is that 40 per cent. of those children have no contact at all with any kind of mental health service.
In fact in The Independent today an article on this very subject highlights the problem. It points out that children with mental health problems are being put at severe risk by long waiting lists to see a psychiatrist. It claims that there is now an average wait of six months and increasing reliance on inappropriate drug treatment. Adrian Worrall, of the Royal College of Psychiatrists, is quoted as saying:
The article quotes a survey of 1,300 GPs by the medical magazine Pulse which found that the average wait for a child psychiatrist appointment was 188 days. Children have to wait 79 days before an initial assessment is made by the child and adolescent mental health service, and a further 102 days before they receive treatment. Some 93 per cent of family doctorsin effect, almost all GPsadmit that they prescribe antidepressants to children because of a lack of alternative therapies, despite safety concerns surrounding the use of drug treatments.
That sets the general scene of mental health services for children and young people, but I want to concentrate this evening on a specific aspect of that carethat is, care for children, and even more specifically, in-patient care for these children. I should stress that I am talking about children, not adolescents, for whom care can often be very different. Many of the children about whom I will talk have specialist and complex needs. Some have neuro-psychiatric disorders that do not respond to out-patient treatment and most of them come from families that need a huge amount of support. Apart from the simple humanitarian need to give those children the best possible care at the earliest possible
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stage, it is clear that children left untreated continue to have a poor quality of life into adolescence and adulthood and sometimes cause wider problems in society.
In-patient treatment for children can have a spectacularly beneficial effect. The children and young persons in-patient evaluation study, commissioned by the Department of Health and published in 2004, showed that substantial improvements could be achieved in the mental health of children admitted to in-patient child psychiatry services. The study made it clear that the subsequent needs of children who had benefited from in-patient treatment were reduced, to the extent that they could usually be treated in a child and adolescent mental healthCAMHScommunity tier 3 service. Further, the improvements in those children were sustained one year after in-patient admission, often with very little further community service provision. So there is little doubt that in-patient services are vital for the small numbers of children who require complex treatment. I have been told by practitioners, especially in child law, that they have seen remarkable results from such in-patient units, including swift turnarounds and remarkable outcomes.
Despite that evidence, the availability of in-patient child psychiatric services seems suddenly to be in precipitate decline. In 2001, the national in-patient child and adolescent psychiatry study showed that in 1999 there were 103 beds in 12 children's units and 46 beds in five general CAMHS units. In 2003, there had been a slight increase to 110 beds. But since then, four children's in-patient services have closed. Shirle Hill in Sheffield no longer provides in-patient care. Stepping Stones in Sutton, Surrey, has closed completely. Larchwood in Haywards Heath now has only two beds as part of an adolescent ward, and an outreach service. Red Oak in Lancaster has closed with a loss of 12 beds, but it may reopen in 2007 although only as an adolescent unit for 12 to 17-year-olds. A bed recount is underway and it is likely to show a reduction in beds to levels substantially below the 1999 figure.
Those closures are bad enough, but three more in-patient services are under imminentI stress the word imminentthreat of closure, including the Park hospital in Oxford; the ward in Birmingham children's hospital; and the West End children's unit in Hull, which currently runs only a skeleton service anyway. If those services close, it will mean a dramatic reduction of about a third in the number of units specialising in that work for children and their families.
This evening, I want to concentrate on one unit in particular which serves my constituents in Oxfordshire and acts a case study of what is happening across the country. The Park hospital in Oxford has provided in-patient care for children for some 50 years. It provides a general service with a strong neuro-psychiatric leaning and highly valued national epilepsy services, based on skills that have been built up over many years. Child psychiatry is a highly specialised area of clinical practice. The closure of the Park is not simply the closure of a hospitalalthough that would be bad enoughbut also risks severely damaging, and probably losing altogether, one of Britain's leading centres for training, research and treatment of child psychiatric disorders.
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What makes the threat of closure even harder to understand is that the child psychiatry service in Oxford and nationally is set to be enhanced by the provision of a specialist scanner, at a cost of some £2.7 million, at the Warneford Hospital in Headington. Its major clinical use will be the investigation of complex epilepsy and the pre-surgical investigation of patients with intractable seizures. Together with the new in-patient facilities that have been promised for so many years, it would have provided the country with an important world-class resource for the management of children with complex interactions between behaviour and epilepsy.
As I said, in-patient child psychiatry is not a service that can be seen merely as an add-on; it cannot suddenly be set up at short notice. It takes years and years to build up the highly specialised expertise that exists at the Park, which must be preserved at all costs. For example, higher specialist training in child psychiatry requires at least six months' full-time experience working in a children's in-patient service, often with a year's follow-up specialist training. There are already unfilled consultant posts across the UK, so the closure of the Park would further reduce training for doctors and other mental health professionals. The possible closure of the Park, which is being carried with little consultationas anyone in the House would understand ithighlights general concerns about the resourcing of child psychiatric services nationwide.
First, it is clear to me that the reason behind the potential closure is undoubtedly financial, although it is being dressed up as a clinical decision. The local mental health trust says that it is inappropriate these days to admit children to hospital, although there is no clinical evidence for that claim. Indeed, I have already mentioned a study that shows that that is not the case. Of course, specialist clinicians will do all they can to avoid admitting children to hospital but in some cases it is unavoidable and is clearly beneficial.
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