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Lords amendment 66 disagreed to.
Government amendment (a) made in lieu of Lords amendment 66.
Lords amendments 3 to 54, 56 to 58, 60 to 65, 67 to 118, 120, 122 to 215, 217 to 235, 237, 238 and 240 to 244 agreed to , with Commons privileges waived in respect of Lords amendments 12, 14, 28, 54, 131, 145, 149, 150 and 185 .
Motion made, and Question put forthwith (Standing Order No. 83H), That a Committee be appointed to draw up Reasons to be assigned to the Lords for disagreeing to their amendments 1, 2, 55, 59, 119, 121, 216, 236 and 239;
That Mr. Bellingham, Mr. Mike Hall, David Howarth, Helen Jones and Bridget Prentice be members of the Committee;
That Bridget Prentice be the Chairman of the Committee;
That three be the quorum of the Committee.
That the Committee do withdraw immediately. -(Mary Creagh.)
Committee to withdraw immediately; reasons to be reported and communicated to the Lords.
Business without Debate
Sittings of the House
That-
(1) at the sittings on Wednesday 11 and Thursday 12 November, the Speaker shall not adjourn the House until any Message from the Lords has been received and any Committee to draw up Reasons which has been appointed at that sitting has reported; and
(2) at the sitting on Thursday 12 November, the Speaker shall not adjourn the House, if a Message from the Lords Commissioners is expected, until that Message has been received .-( Mary Creagh .)
Delegated Legislation
Motion made, and Question put forthwith (Standing Order No. 118 (6)),
That the draft Private Security Industry Act 2001 (Amendment) (Northern Ireland) Order 2009, which was laid before this House on 21 July, be approved.- ( Mary Creagh.)
Motion made, and Question put forthwith (Standing Order No. 118 (6)),
That the draft Private Security Industry Act 2001 (Amendments to Schedule 2) Order 2009, which was laid before this House on 12 October, be approved .-( Mary Creagh .)
Motion made, and Question put forthwith (Standing Order No. 118 (6)),
That the draft Scottish and Northern Ireland Banknote Regulations 2009, which were laid before this House on 13 October, be approved .-( Mary Creagh .)
Motion made, and Question put forthwith (Standing Order No. 118 (6)),
That this House authorises the Secretary of State to undertake to pay, and to pay by way of financial assistance under section 8 of the Industrial Development Act 1982, in respect of the UK Innovation Fund, sums exceeding £10 million and up to a cumulative total of £150 million.- ( Mary Creagh.)
Motion made, and Question put forthwith (Standing Order No. 118 (6)),
That this House authorises the Secretary of State to undertake to pay, and to pay by way of financial assistance under section 8 of the Industrial Development Act 1982, in respect of the Car Scrappage Scheme, an additional sum of up to £100 million .-( Mary Creagh .)
Regional Select Committee (West Midlands)
Resumption of adjourned debate on Question (2 November),
That Mr David Kidney be discharged from the West Midlands Regional Select Committee and Mrs Janet Dean be added.
Debate to be resumed tomorrow.
Regional Select Committee (South West)
Resumption of adjourned debate on Question (29 October),
That Linda Gilroy be discharged from the South West Regional Select Committee and Roger Berry be added .
Debate to be resumed tomorrow.
Tax Law Rewrite Bills (Joint Committee)
That Mr Kenneth Clarke be discharged from the Joint Committee on Tax Law Rewrite Bills and Mr David Gauke be added .-(Rosemary McKenna, on behalf of the Committee of Selection.)
Transport
That Sammy Wilson be discharged from the Transport Committee and Mr Jeffrey M. Donaldson be added .-(Rosemary McKenna, on behalf of the Committee of Selection.)
Statutory Instruments (Joint Committee)
That David Simpson be discharged from the Joint Committee on Statutory Instruments and Mr Nigel Dodds be added .-(Rosemary McKenna, on behalf of the Committee of Selection.)
Petition
Equitable Life (Northavon)
10.23 pm
Steve Webb (Northavon) (LD): This petition relates to the Government's response to the parliamentary ombudsman's report on Equitable Life. The petitioners are policyholders, their survivors and their supporters. The policyholders have suffered maladministration leading to injustice, as found by the parliamentary ombudsman in her July 2008 report. Furthermore, they and those whom they represent have suffered regulatory failure on the part of the public bodies responsible from 1992 onwards, but have not received compensation for the resulting losses and outrage.
The Petition of residents of the constituency of Northavon in South Gloucestershire,
Declares that the petitioners either are or they represent or support members, former members or personal representatives of deceased members of the Equitable Life Assurance Society who have suffered maladministration leading to injustice, as found by the Parliamentary Ombudsman in her report upon Equitable Life, ordered by the House of Commons to be printed on 16 July 2008 and bearing reference number HC 815; and further declares that the petitioners or those whom they represent or support have suffered regulatory failure on the part of the public bodies responsible from the year 1992 onwards, but have not received compensation for the resulting losses and outrage.
The Petitioners therefore request that the House of Commons urge the Government to uphold the constitutional standing of the Parliamentary Ombudsman by complying with the findings and recommendations of her Report upon Equitable Life.
And the Petitioners remain, etc.
Mental Health Services
Motion made, and Question proposed, That this House do now adjourn. -(Mary Creagh.)
10.24 pm
Mr. Charles Walker (Broxbourne) (Con): Thank you for calling me this evening for the Adjournment debate, Mr. Speaker. It is a great honour for me to speak tonight on mental health.
Earlier today, I visited a unit delivering mental health services to my constituents in Hertfordshire. It was a fantastic and enlightening visit. I met a wonderful lady called Sally Pegrum, a nurse who has been in the NHS for 34 years delivering services to mental health sufferers. She trained at 17 and became a mental health nurse at 18. She is still only in her early 50s, so I hope that we will have another eight years of her excellent service.
I asked Sally what changes she had seen in her 34 years of service, and she said that the delivery of mental health services to the most ill in our society has changed out of all recognition. That is a credit to previous Governments and to this Government. When she started 34 years ago, she worked in an institution-and in those days, they were institutions-where she discovered a woman in her 70s who had been there for 60 years for committing the crime of having a child out of wedlock in her early teens. This is recent history-it was not the turn of the century but 34 years ago. Let me start by saying, then, that things have moved a long way in the past 34 years.
I fully support the idea behind keeping ill people in the community and in intermediate care wherever possible. We have crisis resolution teams working towards that aim. The truth is, however, that the reality of crisis resolution teams does not always match the ambition we have set for them. Such teams are often overworked. They have very large case loads, which makes it difficult for the professionals comprising them to give mental health patients the attention they deserve.
There is often a shortage of intermediate and crisis housing, so even if we want to keep mental health patients in the community or near their homes, there are not the facilities to do so. I fully appreciate that efforts are being made to bring this up to speed, but at the moment, those facilities do not exist in many places.
More worryingly or as worryingly, emergency telephone numbers that are meant to operate 24 hours a day are often not manned in the evenings and at the weekend. If someone is having a mental health crisis, it does not always happen in business hours or during weekdays. We need these telephone lines to be staffed 24 hours a day to meet the cries for help. It is also the case that before being admitted to an acute unit with beds, mental health patients are expected to get assessed by these crisis teams, but in 50 per cent. of cases that is not happening. Again, we need to address this flaw in the system.
My final plea is on behalf of carers of people who are mentally ill. I have met many carers who look after people who are extremely ill, and without their help the full burden would fall on the NHS and the taxpayer. We, as a civilised society, need to look after the mental and physical health of these carers, and we need to
ensure that they get excellent respite care, so that they can continue their excellent work on behalf of those whom they love.
I also accept that we are closing beds for the best of reasons, but the truth is that for every three beds that close in hospital wards that do not deal with mental health, six close in mental health wards. I am not going to stand here tonight and argue that mental health wards are particularly nice places to be. In truth, many are not and in fact I have never met anyone who looks forward to going into hospital. Mental health wards are important, however, and they do fulfil a need.
There are problems with existing mental health wards, as I have touched on. About 20 per cent. of patients feel physically threatened in them, while a further 50 per cent. feel threatened at times. A mental health ward is three times more likely to be assessed as being unsatisfactory than a ward treating people with heart disease or cancer, for example. Unfortunately, as my hon. Friend the Member for New Forest, East (Dr. Lewis) knows, such wards are too often located a long way from people's homes.
Dr. Julian Lewis (New Forest, East) (Con): I know a cue when I hear one. Not for the first time, my hon. Friend makes a remarkably eloquent case on the plight of the mentally ill. I was delighted that the brand-new Woodhaven hospital was built and opened in the past few years in my constituency. One reason why its acute ward is not a threatening place to be is that it has alongside it a psychiatric intensive care unit, so that if people get into a threatening state, they can be looked after there-except for the fact that that unit has been temporarily closed and might never reopen. Does my hon. Friend agree that to lose a psychiatric intensive care unit, which functions as a complement to an acute ward, is to make things worse not only for the people in need of the intensive care beds, but for those who need to go from the acute ward, at short notice, into intensive care, and who will now be sent, as he says, a long way away?
Mr. Walker: My hon. Friend makes a valuable point. It is no coincidence that today I visited a PICU-as they are called-an outstanding facility that aids the recovery of some of the illest in our society. I wish my hon. Friend the best of luck in his campaign, and I hope that the primary care trust reconsiders its position. Hertfordshire has an excellent, brand-new facility, which aids recovery.
I am not in favour of keeping acute wards open for the sake of it. However, we must accept that there is a danger of closing wards before the facilities are available in the community to pick up the slack and the patient load. The truth is that in most acute wards, occupancy rarely stands at 85 per cent. In most cases, it is far nearer 100 per cent., averaging 98 to 99 per cent., and can go as high as 125 per cent. when one counts people on leave who are trying to rehabilitate themselves into the community at an intermediate stage, but with the option of a bed remaining open if they have a crisis during that process.
As I am sure the Minister is aware, the pressure on such beds creates problems. When a higher threshold for admittance applies, such acute beds have a higher concentration of seriously ill patients. Staff numbers do not always reflect that situation. The overall number of patients might be the same, but their health needs are
far greater because the admittance threshold is raised. Therefore, more staff need to be in place, because too often they feel that they are managing patients, as opposed to treating and making them better, which is what mental health staff want to do.
I mentioned the issue of leave: many patients leave acute mental hospitals to have a couple of days in an intermediate setting to help them to integrate back into their community. However, many patients are frightened to go on leave because they fear that if they have a crisis they will never get back into hospital, as the demand for their bed becomes so pressing while they are on leave that it is given up. Psychiatrists report anecdotally a greater pressure to discharge patients early, which results in far higher rates of readmission. Also-I hope the Minister does not think that I am arguing against myself-bed blocking can occur, because the patient is at a stage at which they can be moved on, but the intermediate services between them and the community are not in place to take them on board. I notice my hon. Friend the Member for New Forest, East getting restless, and I will allow him to intervene again.
Dr. Lewis: I promise that this will be my last intervention. I had not intended to make it, but as my hon. Friend has referred to rehabilitation in intermediate stages, I must draw attention to the fact that Crowlin house-a state-of-the-art rehabilitation centre in Totton, in my constituency-is threatened with closure. It has been reprieved for the moment because no places have been found for residents to be sent in the meantime, but once again, exactly the scenario that my hon. Friend is describing in theory is developing in practice in my Hampshire constituency.
Mr. Walker: As the Minister knows, such intermediate services are critical. The closure of wards works only when there are good intermediate services that ease patients' return to the community.
One of my concerns about the additional pressure being placed on acute wards relates to staff turnover. If staff no longer feel that they are in control of the situation-if they feel under intolerable pressure-they are tempted to move on, and many staff who are experienced in hospital settings are now moving to crisis management teams. That is no bad thing, because they bring their experience with them, but we need equality of service. We need excellent people in the community, but we need excellent people in our hospitals as well.
I never thought that in my parliamentary career, I would talk about a balanced score card-it sounds very exciting and new-but I think we need one in this instance. When we are, rightly, closing hospital beds and reducing a hospital ward's capacity from 22 to 16, as is suggested by best practice, we should have that balanced score card. We should ensure, before the closures happen, that there are community facilities to take the increased load that will be moved back into the community. We should ensure that we have the intermediate beds, the safe houses and the respite care for carers that will make the transition work. We in this place want to be confident that the system works. We want to be confident that our constituents are being given the very best care, and that applies across the House this evening.
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