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Child/Adolescent Psychiatric Services (North-West)

9. Dr. John Pugh (Southport) (LD): How long the average waiting time for accessing child and adolescent psychiatric services in the north-west is. [255403]

The Minister of State, Department of Health (Phil Hope): Information from the annual children and adolescent mental health services—CAMHS—mapping exercise, conducted by Durham university for the Department of Health and the Department for Children, Schools and Families, indicates that NHS trusts in the North West Strategic Health Authority have waiting times for CAMHS that are better than average. During 2007-08, 91.6 per cent. of new referrals for CAMHS were seen within 13 weeks in the North West SHA area, compared with 87.4 per cent. in all strategic health authorities.

Dr. Pugh: I have a letter from a whistleblower who alleges a serious scandal in the north-west, citing CAMHS waiting lists of one year for serious and complex tier 3 needs, a lack of resources, a shortage of in-patient beds, and looked-after children being dumped in private homes. May I ask the Minister seriously to look further into the information that he has and to check its accuracy?

Phil Hope: I will certainly take away the information that the hon. Gentleman has presented this afternoon and respond to him in due course. I am aware that one of his constituents had to wait 12 months for referral to the children and family services. I understand that Sefton primary care trust is now working with Alder Hey Children’s NHS Foundation Trust to introduce waiting time initiatives to ensure that the PCT in the hon. Gentleman’s constituency meets the waiting-time targets across the borough. That includes extra temporary staff and introducing “choice and partnership”—a new system for the management and referral of patients. The hon. Gentleman has raised a serious point on the Floor of the House; I will take it away and write to him in due course.


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Mrs. Madeleine Moon (Bridgend) (Lab): The early intervention of child and adolescent mental health services is as serious an issue in the north-west as it is for the rest of the UK, as failure to access child and adolescent mental health services can lead to long-term mental health problems for youngsters. We know that between 10 and 20 per cent. of young people will have such long-term difficulties, which can lead to suicide, long-term mental health problems and self-medication with drugs and alcohol, so will my hon. Friend agree to look seriously at how we can bring about improvements to child and adolescent mental health services across the UK?

Mr. Lindsay Hoyle (Chorley) (Lab): This is a north-west question.

Mr. Speaker: Order. The hon. Lady linked her question to the north-west, and she was entitled to raise it. It was a wee bit long for a supplementary; perhaps we could cut the supplementaries down a little.

Phil Hope: My hon. Friend the Member for Bridgend (Mrs. Moon) has raised the concerns in her constituency on many occasions both inside and outside the House. I am grateful and pleased that, so far as I am aware, all of them are not replicated in the north-west. I agree that gaining earlier access to services for children and adolescents with mental health problems is a serious matter. We have undertaken a review of this country’s child and adolescent mental health services; funding went up from £322 million in 2003-04 to £523 million in 2006-07, and there has been a significant fall in the number of people waiting, along with shorter waiting times for CAMHS. However, there is more to be done and the Department will make sure that we press forward on these issues because our children and young people deserve the best mental health service that we can provide.

Norman Lamb (North Norfolk) (LD): How can the Minister justify the fact that someone with a physical health condition will have an operation within 18 weeks of referral from a GP, whereas someone suffering from a mental health condition can find themselves waiting—as my hon. Friend the Member for Southport (Dr. Pugh) said, in the north-west and in many other parts of the country—sometimes more than a year for cognitive behaviour therapy and other NICE-approved therapies, particularly when we know that early intervention is very important in aiding recovery? Is it not about time that we ended this discrimination in the health service—for that is what it is—and ensured that people with mental health problems had an entitlement to access treatment?

Phil Hope: The hon. Gentleman will know that over the next 12 months we are launching the “new horizons” project, which is our strategy to take mental health services forward. He and I have appeared on many platforms together, celebrating the significant improvements in mental health services, as major investment means that we have many more psychiatrists and psychiatric nurses than we have ever had before. The real challenge in front of us, however, is not only to ensure that we maintain that improvement in mental health services, but to challenge the wider stigma and discrimination attached to people who have mental health problems. That means bringing about a cultural shift so that we
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not only continue to improve mental health services by putting in investment, as we have over the last 10 years, but move forward towards genuinely healthy communities, which means mentally healthy communities. We need to take away and end the stigma currently attached to people who suffer from mental health problems.

Anne Milton (Guildford) (Con): The figures for the north-west are, like those for the rest of the country, truly shocking, with one in 10 five to 16-year-olds having a clinically significant mental health problem, including anorexia, anxiety and depression—one in 10: the numbers are huge. Furthermore the use of anti-depressants on children has increased 38 per cent. over the past 10 years. These shocking figures clearly demonstrate the failure of our child and adolescent mental health services. Although I welcome the Government’s attempts to do something about it, the Minister should, to be fair, admit that children and adolescents have been failed over the past 11 years and that we are now seeing the results in the increase in the mental health problems of young adults.

Phil Hope: No, I do not accept that the Government have failed. What I do accept is that there has been a significant increase in funding for children’s and adolescents’ mental health services, from £322 million in 2003-04 to £523 million—half a billion pounds—in 2006-07. That has produced a fall in the number of children and young people waiting to be seen, and it has reduced waiting times. Nevertheless, there is clearly more to be done. That is why we instigated the review, that is why are setting up a new national advisory council, that is why we are setting up a national support programme, and that is why we are driving forward changes up and down the country to ensure that children and adolescents with mental health problems— [Interruption.] The hon. Lady says, from a sedentary position, “Eleven years”. I can remember the 18 years of a Conservative Government who failed to invest a single penny in children’s and adolescents’ health services.

Topical Questions

T1. [255420] Miss Julie Kirkbride (Bromsgrove) (Con): If he will make a statement on his departmental responsibilities.

The Secretary of State for Health (Alan Johnson): The responsibilities of my Department embrace the whole range of NHS social care, mental health service and public health service delivery, all of which are of equal importance.

Miss Kirkbride: I welcome the Government’s campaign to alert people to the symptoms of stroke and to encourage them urgently to seek medical treatment, but what reassurance can the Secretary of State offer that every hospital in the country will be given adequate resources with which to deal with the increase in demand, especially in scanning departments? What guarantees can he give those who may present at hospitals with stroke symptoms that they will be given the timely treatment that they need to ensure that their future health is not impaired?


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Alan Johnson: I can reassure the hon. Lady that the 20-year stroke strategy that we set out in December 2007 will be completed. However, there comes a point when there must be a drive to increase awareness along the way, and a debate has been held with the Stroke Association and others about when that should happen.

As the hon. Lady implies, we are not at the end of the stroke strategy yet, and not every treatment centre has the best facilities that we want to see throughout the country; but the view expressed in the debate was that now was the time to raise awareness and, in particular, to make people aware of FAST—the face, arm, speech test, which paramedics have used for some time. Strokes, probably more than any other illness or attack, require early treatment and a scan within the first three hours: that is essential. One of the main problems is a lag at the beginning because either the person having the stroke or those around him or her do not realise that it is a stroke.

This is the right time for a public awareness campaign. Meanwhile, we recognise that there is more to be done to ensure that services around the country are uniformly excellent.

T5. [255424] Mr. Graham Allen (Nottingham, North) (Lab): Does the Secretary of State—or the Minister of State—welcome a publication on teenage pregnancy produced by the Nottingham teenage pregnancy taskforce, and will he or she underline the fact that this is everybody’s problem? It is not just a health service problem about contraception; it is as much about ensuring that young people have the life skills and the social and emotional capability to enable them to make the right choices when they become sexually active.

The Minister of State, Department of Health (Dawn Primarolo): I congratulate my hon. Friend on the leadership that he is showing in his city in relation to young people’s opportunities and life chances, and, in particular, on the publication about preventing unplanned teenage pregnancy in Nottingham, of which he gave me a copy last week. In all areas, the important factors are leadership, shared objectives and a clear focus on ensuring that young people are given the sexual health education that crucially influences the choices that they make for the rest of their lives.

T2. [255421] James Duddridge (Rochford and Southend, East) (Con): Southend hospital has banned visitors from bringing in flowers on health and safety grounds. Does the Minister believe that flowers present a real risk to patients?

Alan Johnson: The hon. Gentleman raised the issue with me last summer, and I wrote to him about it on 27 June. It is a matter for the local trust. At that time the trust was beginning a consultation, to which I hope the hon. Gentleman contributed, and I understand that it established that there was 75 per cent. public support. The Department does not recommend the banning of flowers other than where they cause particular problems to patients, but we consider that this is an issue for local trusts, and that we should not dictate to them from the centre.

T6. [255425] Mrs. Linda Riordan (Halifax) (Lab/Co-op): Recently, more than a quarter of care homes in Calderdale, which includes my Halifax constituency,
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were given the lowest two ratings by the Commission for Social Care Inspection. Does the Minister agree that many care homes are more intent on making a profit than on looking after the elderly, and will he tell me what improvements will be made to the standard of care, and what sanctions will be imposed on those who do not comply?

The Minister of State, Department of Health (Phil Hope): It is essential that we continue to improve the quality of residential care for older people, and I appreciate my hon. Friend’s concerns, but I am pleased to be able to say that the most recent annual report on the state of social care by CSCI inspectors shows the sixth successive year of improvement against the national minimum standards for care homes that we established in 2003. The commission is also taking action to drive up the quality of residential care further. The performance ratings it awards to councils will be affected if those councils only purchase services from care homes rated as poor or adequate. I hope that, together, we will drive up the performance of care homes, so that older people can expect to be looked after with dignity in their retirement.

T3. [255422] Mr. Andrew Pelling (Croydon, Central) (Ind): The campaigning social issues journalist in Croydon, Aline Nassif, has revealed two very worrying cases regarding my constituents. The Mayday hospital accident and emergency department turned away a young mother many times, saying she had depression; she subsequently died from swelling of the brain. There is a very similar story of a young teenager who was also misdiagnosed. While I should, perhaps, have performed the courtesy of advising Ministers before raising this matter in the House, and although Mayday is clearly unable to comment at present as these matters are now under investigation following media coverage, might consideration be given to supporting Mayday, in terms of proper co-ordination and diagnosis at its neurological and accident and emergency departments, while such investigations are ongoing?

Alan Johnson: As often happens in topical questions, we are hearing about things for the first time. I will be very pleased to look into this matter and see whether there is, indeed, a case for Mayday improving its neurological services, and I will also be very pleased to meet the hon. Gentleman to discuss it.

T7. [255426] Joan Walley (Stoke-on-Trent, North) (Lab): May I draw the Minister’s attention to a scrutiny review that is taking place in Staffordshire of the contracts that the primary care trusts have with the independent sector treatment centre in Burton? People in Stoke-on-Trent by and large do not want to go to Burton for treatment, and they do not want to be cross-subsidising health care at their expense. Can my hon. Friend confirm that the letting of the new contracts will be determined locally by the primary care trusts?

The Minister of State, Department of Health (Mr. Ben Bradshaw): Not if that means withdrawing from the public the choice that I hope my hon. Friend agrees with us they are entitled to.


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T4. [255423] Mr. David Evennett (Bexleyheath and Crayford) (Con): Since 1997, almost 800 organs from British donors have gone to people resident outside the United Kingdom. Over the same period, the list of British people waiting for organs has increased by more than 2,400, while only 140 organs have been brought into this country from abroad. Do not the Government need to take some action as this situation is rather shambolic, and does not the Secretary of State need to get a grip on it?

Alan Johnson: We might need to take some action. As I understand it, this matter involves a few hospitals, and NHS Blood and Transplant has not been happy with the situation—its correspondence was leaked to the press over the weekend. The organ donation taskforce has been looking at a number of very important elements of organ donation, but we did not ask it to look at this issue because at the time it was not highlighted as a problem. We might need to do so, however, because the hon. Gentleman raises a serious point: we want to increase the number of people on the register, and if people think they are going on the register for their body organs to be part of some export system, that will not do us any favours in achieving that end, so we need to tackle this, and to tackle it quickly.

T8. [255427] Lorely Burt (Solihull) (LD): Will the Secretary of State reassure me that it would not be acceptable for a Labour Government to endorse surplus taxpayers’ money from an NHS hospital trust being used to create a private hospital to be run by that trust? Would that not fly in the face of the ethos of the NHS, create a conflict of interests when services are being delegated, and involve taxpayers in the risk if that private venture were to fail?

Alan Johnson: I would like to know the details of what the hon. Lady is describing. My local acute trust at Castle Hill has purchased the private Nuffield hospital and brought it into the NHS—it says that it had to spend lots of money to bring that hospital up to NHS standards, although that may or may not be true. I shall look at the point she raises, because it sounds like it involves a deeper story.

T10. [255429] Ben Chapman (Wirral, South) (Lab): Merseyside and Cheshire Cancer Network proposes to move cancer services from Clatterbridge to Liverpool, not on the basis of an objective, transparent and rigorous process or a proper business plan, but because the money is available. Will the Minister meet me and my colleagues, so that we can discuss our objections to both the form and substance of this?

The Parliamentary Under-Secretary of State for Health (Ann Keen): Yes, I would be happy to meet my hon. Friend.

Sir Patrick Cormack (South Staffordshire) (Con): Is the Secretary of State aware that when I was first elected to this House, almost every GP practice in my constituency offered an out-of-hours service? Despite the dramatic advance in medical treatments and drugs, my constituents receive a much less personal service from their GPs than they did 30 to 35 years ago. Does he agree that that is not progress?


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Alan Johnson: No, I do not, and I shall tell the hon. Gentleman why. At the turn of the century, there was a very serious problem with getting medical students to go into general practice. The forecast, given the demography of general practices then, was that the shortage was bad and would become much worse, so something had to be done. Since the new contract, we have given GPs the option to opt out of 24-hour cover, and the vast majority of them—all bar 10 per cent.—have done so, despite the fact that it has meant a reduction in their pay. We have moved from a system where GPs would look at someone at 9 am having only struggled into bed at about 6.30 am because they had been called out through the night—the situation was similar to the long hours that junior doctors worked, which seemed to be some kind of badge of courage. Tired doctors are not good for our health service, and I am very pleased that we have moved beyond that archaic system.

Mr. David Crausby (Bolton, North-East) (Lab): My local newspaper, The Bolton News, recently reported that a 29-year-old woman in the Royal Bolton hospital was so terrified in a mixed-sex ward with three men that she was forced to sleep in the examination room overnight. Is it not bad enough being ill in hospital without having to deal with the added stress that mixed-sex wards cause men and women? When can we expect to see the end of these wards in Bolton? [Interruption.]


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