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Sir George Young: I understand the concerns of those who have lost a child in the tragic circumstances that my hon. Friend has described. I will certainly pursue with the Department of Health whether a certificate can be issued in such circumstances. I will ask the Secretary of State to respond to my hon. Friend as sympathetically as he can.
Kevin Brennan (Cardiff West) (Lab): The Queen’s Dragoon Guards, the Welsh cavalry, are in Westminster today lobbying about the future of their regiment because of the concern that the Government will cut it. May we have a debate on the future of the Welsh regiments, with particular reference to the undermining of support for the Union that any further weakening of them would engender?
Sir George Young: I was at Defence questions on Monday, where the future of the regiments was raised. Speaking from memory, I believe that my right hon. Friend the Secretary of State said that work was still under way on the appropriate configuration. There is a Westminster Hall debate on Armed Forces day next Tuesday, which may be an opportunity for the hon. Gentleman to raise the matter when a Defence Minister will be responding.
Alun Cairns (Vale of Glamorgan) (Con): The previous Government left Wales as the only nation in the UK without a single mile of electrified railway. Many Government Members are lobbying the Secretary of State for Transport about the electrification of the railways. May we have a statement on the matter to find out her latest thinking?
Sir George Young: If I remember rightly, my right hon. Friend the Secretary of State for Transport has announced the electrification of the Great Western line to Cardiff. I am sure that that has been well received in Wales. There will be an opportunity the next time we have Transport questions to press the Government on their plans to invest further in the railways in Wales. Alternatively, my hon. Friend could seek a debate on the matter in Westminster Hall or on the Adjournment of the House.
Nic Dakin (Scunthorpe) (Lab): May we have a statement on the performance of the Child Support Agency, and in particular on the effectiveness of its support for the children of absent parents who are self-employed?
Sir George Young: There will be an opportunity to put question to the Secretary of State for Work and Pensions on Monday week. We all know from our advice bureau that the CSA is raised with us as a regular issue. If there is a particular instance that concerns the hon. Gentleman, I suggest that he writes to the Secretary of State to see whether he can usefully intervene and put matters right.
Gavin Barwell (Croydon Central) (Con):
Some small and medium-sized businesses in my constituency still report difficulties in accessing finance. Although I welcome the Government’s national loan guarantee scheme and the business finance partnership, may we have a debate
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on what else can be done to ensure that companies can access the working capital that they need to drive growth and create jobs?
Sir George Young: The Government have introduced a range of initiatives, including the StartUp Loans scheme and the GrowthAccelerator programme. The £82.5 million StartUp Loans scheme is aimed at younger people who want to set up their own businesses. The £200 million GrowthAccelerator programme is for 26,000 of England’s most ambitious small businesses, some of which I am sure are located in Croydon.
Jim Shannon (Strangford) (DUP): Recently, the Department for Environment, Food and Rural Affairs commissioned a report from the Wildfowl and Wetlands Trust on banning lead shot for wildfowlers and on wildfowling shooting grounds. That has caused consternation among members of the Countryside Alliance and the British Association for Shooting and Conservation. Will the Leader of the House agree to a statement or a debate in the House on that matter?
Sir George Young: I cannot promise an early debate, but it is an issue that the hon. Gentleman might raise on the Adjournment of the House or in Westminster Hall. I am sure that Members from both sides of the House would be interested in taking the matter further.
Robert Halfon (Harlow) (Con): Has my right hon. Friend seen early-day motion 167, which campaigns for Rachel’s law?
[That this House deeply regrets the fact that Mrs Annette Courtney, a mother from Harlow, has had to sell her family home to enable her daughter to live independently; notes that her daughter Rachel is 20 and has cerebral palsy and high functioning autism, but that she has achieved five GCSEs and is on target to gain a BTEC Level 3 in IT and an AS level in business studies; further notes that Mrs Courtney has recently said that “Social Services have been involved in our lives for the last two and a half years and we have been completely disempowered by the system… Having stated that Rachel wishes to leave home when she leaves residential college and having experienced life away from home for the last two years, no accommodation has been found to rent. Every avenue that I have explored has been closed down and I am now in the process of selling my home to buy her a flat which will leave me homeless”; concludes that Rachel is one of thousands of young adults with disabilities who are sent home with no opportunity to develop their skills, or enter the workplace; and therefore calls on the Government to bring forward proposals for Rachel’s Law, so that all post-19-year olds with a disability, or disabilities, should they choose to leave home, would have adapted accommodation available to them to rent.]
Annette Courtney from my constituency of Harlow has had to sell her home to raise funds to ensure that her adult daughter, who has special needs, gets suitable accommodation. May we have a debate on a level playing field for young people with special needs?
Sir George Young:
I understand my hon. Friend’s concern. My understanding is that the disabled facilities grant is aimed specifically at families such as the one
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that he has mentioned to enable them to stay in their own home. In the last spending review, we sought to ring-fence the DFG money so that the resources were available to ensure that people did not have to move home if their existing home could not cope with a particular disability. I will make inquiries with the Department for Communities and Local Government to see whether there is any action that we can take to help his constituents.
Jeremy Lefroy (Stafford) (Con): Constituents of mine have been through the considerable distressed of seeing their son’s killer in an area from which he was excluded by bail conditions, yet he was not returned to prison. May we have a debate on the rights of victims in those circumstances?
Sir George Young: It sounds as though it was a matter for the court in the first instance, when it discovered that the bail conditions had been broken, to return the offender to jail. However, I understand the concern of my hon. Friend’s constituents, and I will raise the circumstances that he mentions with my right hon. and learned Friend the Justice Secretary to see whether any action ought to be taken to ensure that bail conditions are properly enforced.
James Morris (Halesowen and Rowley Regis) (Con): The number of new apprenticeship starts has doubled in my constituency in the past two years, and I recently launched an apprenticeship challenge specifically to encourage small local firms to take on an apprentice for the first time. May we have a debate about how we can encourage small firms to take on apprentices, so that we get the skilled and flexible work force that we need?
Sir George Young: I welcome what my hon. Friend has done, and more MPs could do the same and remind local employers of the resources that are available if they take on an apprentice. Some £1,500 is available towards the cost of doing so, and we have just made available resources that will support up to 40,000 new apprenticeships. I would welcome such a debate, but I fear that I cannot promise one in Government time in the immediate future.
Harriett Baldwin (West Worcestershire) (Con): May we have a statement on security at the Palace of Westminster? Following the theft of two laptops from my locked office in Norman Shaw North during the jubilee recess, I have learned that there have been 39 such thefts in the Palace of Westminster over the past 12 months. Such a statement or debate would enable colleagues to learn about best practice in securing their valuable items.
Sir George Young: I very much regret the theft from my hon. Friend of two laptops, which, as she said, were in a locked room. I have had a discussion with the Serjeant at Arms about this matter, and he takes it extremely seriously and is following it up. My hon. Friend reminds us, and indeed our staff, that we should take whatever precautions we can to ensure that we do not leave valuable equipment in unlocked rooms, to reduce the temptation towards such thefts.
Mr Speaker: I call Christopher Pincher.
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Christopher Pincher (Tamworth) (Con): Thank you for recognising me, Mr Speaker.
Mr Speaker: I think the hon. Gentleman is referring not to an achievement on the part of my eyesight as such but to the fact that his own appearance has changed notably from that of earlier days. I say that for the edification of people who might be attending to our proceedings. We look forward to hearing him.
Christopher Pincher: All our appearances have changed since earlier days, Mr Speaker, as you and I well know.
Youth unemployment in Tamworth has fallen to a 12-month low, thanks in part to further investment in Jaguar Land Rover and in BMW in Hams Hall. May we have a debate on the steps that the Government are taking and will take to reduce business taxation and regulation further, so that businesses can expand and create more jobs?
Sir George Young: My hon. Friend’s beard has been enormously welcomed by the Deputy Leader of the House. In a week or two, he may even be able to match the hirsute nature of the Deputy Leader of the House’s face.
My hon. Friend is right that the investment by Jaguar Land Rover and BMW has had an enormous impact. On what more the Government can do, on Monday we had Second Reading of the Enterprise and Regulatory Reform Bill, which contains a number of measures to overhaul employment tribunals and create a more enterprise-friendly society. The Government are on the case.
Glyn Davies (Montgomeryshire) (Con): Last week, Trax JH Ltd, a motor components manufacturer in my constituency, announced a £4 million order from Renault, which safeguarded 50 jobs in the constituency. That was a hugely important announcement. Will the Leader of the House provide an early opportunity for us to discuss the importance of the close, pragmatic working relationship between the United Kingdom Government, the devolved Governments and the providers of finance, which underpinned the announcement?
Sir George Young: I very much hope that the firm in my hon. Friend’s constituency has the resources that it needs to deliver the order that it has just won. We have close dialogue with Welsh Assembly Ministers to promote the best output for UK Ltd.
I mentioned a moment ago that the recent figures from the motor industry were encouraging. The number of cars built in the UK last month showed an increase of more than 40% on the same time last year, and I am sure Members of all parties will welcome that figure.
Mr Speaker: I am grateful to the Leader of the House and other colleagues for their co-operation.
Greg Mulholland (Leeds North West) (LD): On a point of order, Mr Speaker.
Mr Speaker: Points of order will follow the statement on banking reform.
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Banking Reform
12.44 pm
The Financial Secretary to the Treasury (Mr Mark Hoban): With permission, Mr Speaker, I would like to make a statement on banking reform.
The financial crisis exposed a great many flaws in the system. Banks borrowed too much, took risks they did not understand and bought securities that proved to be far from secure. Banking groups became too complex and interconnected to be managed effectively, regulators failed to identify the risks and taxpayers paid the price. Between October 2008 and December 2010, European taxpayers provided almost €300 billion to prop up their banks, with liquidity and lending support in the trillions. In the UK, the bail-out of RBS was the biggest banking bail-out in the world.
Just as the crisis revealed many flaws, there is no single solution. The Government are reforming the substance and structure of the financial architecture, putting the Bank of England in charge of prudential regulation. We have created the Financial Policy Committee to look at risks across the financial system. Our permanent bank levy penalises short-term wholesale funding, and we have introduced the toughest and most transparent pay regime of any major financial centre in the world. We have worked with our international partners to deliver robust, consistent prudential standards for banks and markets.
The White Paper that we are publishing today sets out how we will implement the recommendations of the Independent Commission on Banking. The Government’s reforms will form a key part of our broader programme of reform. In the same way that the action we have taken on the deficit has meant that UK debt is currently seen as a safe-haven asset by investors around the world, we will ensure that British banks will be resilient, stable and competitive, and so attractive to investors at home and abroad.
The eurozone crisis makes reform more, not less important. The link between the strength of a country’s banking sector and that country’s stability could not be clearer. At the same time, our proposals reflect the progress that has been made in European and international regulation since December. The Government welcome the European Commission’s bank recovery and resolution directive, which will improve member states’ ability to resolve cross-border banks without imposing costs on taxpayers. We will also continue to press for full Basel III implementation in Europe.
The goals of today’s White Paper are clear. First, since financial crises rarely repeat the pattern of the past, we must ensure that banks are more resilient to shocks. Secondly, we must make our banks more resolvable, so that if they fail, they do not threaten the provision of vital services to the real economy. Seeing through those two goals will achieve our third—to curb risk-taking in financial markets. It must be clear that investors reap rewards when banks do well, but take the pain if banks fail.
The Government will ring-fence retail deposits from the risks posed by international wholesale and investment banking. A ring-fenced bank will be economically and legally separate from the rest of its group and run by an independent board. The ring fence will not in itself
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prevent a bank from failing, but it will insulate the deposits of families and businesses, and if a bank does fail those essential parts of the banking system can continue without recourse to the taxpayer.
The deposits and overdrafts of individuals and of small and medium-sized businesses will, in general, be placed in ring-fenced banks. To minimise the risks that a ring-fenced bank is exposed to, it will be prohibited from conducting the vast majority of international wholesale and investment banking. It will not be permitted to carry out activities through branches or subsidiaries outside the European economic area, or, except in limited circumstances, with financial institutions. Beyond that, and within certain constraints, firms may decide what to put inside the ring fence. Ring-fencing will provide customers with flexibility, but not at the cost of financial stability.
The Government also propose to strengthen the ICB’s recommendations by applying strict controls to the use of derivatives by a ring-fenced bank to hedge its balance sheet. That will ensure that a ring-fenced bank does not take excessive risks when managing its own risks, as was the case with J. P. Morgan’s much-publicised trading loss.
Governance of the ring-fenced banks will be important. The Government propose to strengthen the ICB recommendations in that area, establishing separate risk committees and possibly also separate remuneration committees. However, it is important to focus these reforms where they will have the biggest impact, which is on the biggest, too-big-too-fail banks. We therefore propose that smaller banks, with less than £25 billion of mandated deposits, will be exempt from those requirements. Large, systemically important banks gain a competitive advantage from the perceived implicit guarantee. Our targeted reforms will remove that advantage, helping smaller banks and new entrants.
One of the clearest lessons from the crisis is that investors and creditors, not taxpayers, should bear the costs of failure. That is why we have supported Basel III, which increases bank capital to 7%, with a top-up for systemically important banks, and why we have pressed for that to be implemented across Europe, but to protect taxpayers, the Government will go further. The largest UK ring-fenced banks should hold an additional 3% of equity on top of the Basel III minimum numbers. The Government also strongly endorse the introduction of a binding minimum leverage ratio. The White Paper supports the Basel proposal of a 3% leverage ratio for all banks, including UK ring-fenced banks, and we will continue to press for the implementation of the Basel standard through EU law.
Large ring-fenced banks should hold a minimum amount of loss-absorbing capacity—made up of debt or equity—of 17% of risk-weighted assets. Their overseas operations should be exempt from that requirement unless they pose a risk to financial stability. For smaller UK banks, as the ICB recommends, the minimum requirement should be lower.
To deliver those proposals, the authorities need a way to “bail in” bank liabilities so that bondholders, not taxpayers, bear the losses. The Government will work with European partners to ensure that the ICB recommendations on bail-in are credibly and consistently applied across
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Europe through the recovery and resolution directive. We intend to introduce the principle of depositor preference for insured deposits. Unsecured lenders to banks are better placed to monitor the risks that banks are taking and should take losses ahead of ordinary depositors.
Our proposals on financial stability also improve competition in UK banking. The implicit guarantee to large banks distorts competition; its reduction will help to create a level playing field. However, we want to do more to encourage new entrants and promote competition. We will shortly issue a consultation on reform to the payments system. I welcome the reviews by the Bank of England and the FSA into the prudential and conduct requirements for new entrants to ensure that they are appropriate and not disproportionate. We strongly support the need for a stronger challenger bank to emerge from the Lloyds Banking Group divestment. We are engaged with Lloyds and the European Commission to ensure that the divestment process creates as strong a challenger as possible. A more competitive banking system will work only—[Interruption.]
Madam Deputy Speaker (Dawn Primarolo): Order. Government Members do not need assistance from the Opposition on where they should sit. The Minister is making a serious statement to the House. Perhaps Opposition Members could hear what he has to say.
Mr Hoban: That really sums up the Opposition. All they can talk about is who sits where. They have no ideas on how to resolve this banking crisis.
I welcome the reviews by the Bank of England and the Financial Services Authority into the prudential and conduct requirements for new entrants to ensure that they are appropriate and not disproportionate. However, as I have said, a more competitive banking market will work only if consumers are prepared to change banks. The Government are pleased with the progress on the industry-led initiative to make current account switching faster and easier for customers. Providers covering 97% of the current account market have signed up and the scheme is on track to be launched next September. However, to switch, customers need better information, so the Government welcome the fact that the Office of Fair Trading and the Financial Conduct Authority will take forward the ICB recommendation to improve transparency across all retail banking products. Work is already under way on a number of projects, such as making account data available to customers electronically, to enable them to shop around.
Financial stability is a prerequisite for growth. Our analysis suggests that the proposals in the White Paper will cost, in gross domestic product terms, in the region of £0.6 billion to £1.4 billion per annum. However, that should be compared with the estimate that the 2007 to 2009 crisis has already cost the UK economy £140 billion, which is one hundred times the maximum cost estimate of our proposals.
The proposals, although ambitious in scale, are proportionate in impact. They will promote financial stability while supporting sustainable growth and making the UK’s role as the world’s leading international financial centre secure. The reforms we are announcing today, together with the changes we are making to the regulatory architecture, demonstrate that the Government are
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determined to take action to deliver a stable and sustainable banking sector that underpins rather than undermines economic growth. I commend this statement to the House.
12.54 pm
Ed Balls (Morley and Outwood) (Lab/Co-op): Let me begin by thanking the Minister for notice of today’s Treasury statement on the vital issue of banking reform. The reforms are so important that—we read in the newspapers—they are to be the subject of the Chancellor’s Mansion House speech tonight.
The Minister said the statement was serious, and I am sure Opposition Members and Government Members will all be thinking: “Why is the Chancellor not making it?” Should I call him the part-time Chancellor? He was able to spend the afternoon on the Government Bench yesterday to support the embattled Secretary of State for Culture, Olympics, Media and Sport, but he is seemingly unwilling, despite media trails, to come to the House today. What is the Chancellor running scared of? Is he too busy this week on his other duties to be the Chancellor, or is the truth that he is ducking answering the questions because—once again—he is not on top of the details of his brief?
There are questions to answer. Last September, the Opposition welcomed the report by Sir John Vickers and the Independent Commission on Banking, which sets out radically to reshape our banking industry. We urged the Government to implement the reforms without foot-dragging or watering them down, but I fear that watering down is where we are heading. Is not the truth that, having failed to secure international agreement in Brussels and Basel on tougher international banking standards, the Chancellor is now being forced to water down and fudge the Vickers reforms?
That is one area in which the Opposition would not welcome a U-turn from the Chancellor. The Minister will say in his response that I am wrong, and that there is no U-turn, just as Ministers said we were wrong to spot U-turns on pasties, caravans, churches, charities and skips, but a pattern is emerging with this Chancellor. He declares, “This Chancellor is not for turning,” and then sends along a hapless junior Minister to do the job for him. We can ask the Exchequer Secretary all about that.
If the Chancellor is not watering down Vickers, why will he not agree to the Opposition’s request to ask the Vickers commission to come back this autumn and publish an independent report on progress in implementing its reforms in the past 12 months? The Chancellor could publish that report alongside the autumn statement, when he will have to come to the House to explain why his failing economic plan has plunged our economy back into recession. That is one area where a U-turn would be warmly welcome.
On progress against the three tests for banking reform, first, to protect taxpayers, the Opposition support the Vickers conclusion that banking services should be safeguarded and ring-fenced. In November 2006, the Minister told the House that
“light-touch…regulation is in the interests of the”
“sector globally.”—[Official Report, 28 November 2006; Vol. 453, c. 995.]
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May I ask this champion of light-touch regulation to explain why, contrary to Vickers, it is right to allow retail banks inside the ring fence to trade in derivatives and hedging products, which are among the controversial interest rate swap products that many small firms complain they were mis-sold in recent years? I have said many times that the previous Government got bank regulation wrong. Those on the Government Front Bench also got it wrong, but they are getting it wrong again. The Chancellor should be careful about leaving the door too wide open.
The Opposition agree with the Vickers view that we need a minimum leverage ratio and higher equity requirements for larger ring-fenced banks, but will the Minister confirm that the Chancellor is setting a lower minimum leverage ratio than the Vickers commission recommended, and that he is departing from the recommendation that larger banks should have tougher rules?
The Chancellor implied in December that he would mandate those services specifically within the ring fence to provide clarity and certainty. Can the Minister explain why the Chancellor is now delegating that detailed task to the Bank of England—the regulator—and not putting it in primary legislation? Will the Chancellor—or, on his behalf, the Minister—commit to inserting in the Bill the requirement that large UK retail banks should have equity capital of at least 10%? Is not the real problem that the Chancellor is not in the driving seat on this agenda?
That takes me to our second test, on international agreements. In December, I asked the Chancellor whether he was confident that he would get the necessary international and EU-wide agreements to implement Vickers. The answer is that he has not succeeded in delivering that. The Chancellor himself said at last month’s ECOFIN, when he refused to agree to an EU statement on capital requirements, that they would
“make me look like an idiot”—
a muttering idiot perhaps! Two weeks later, though, he signed up to exactly the same deal. The problem is that there remains the risk that he will be overruled by the EU.
There is a wider problem. We agree with the Chancellor that the UK should not contribute to a eurozone-wide deposit insurance scheme, but the Commission’s proposals go much wider and are said to be intended to apply to the 27. The Chancellor gives the impression that he has a veto on the plans, so that they would apply only to the 17. Will the Minister tell us, then, whether the proposals for Europe-wide banking supervision will be subject to qualified majority voting under existing treaties, and will he tell us how the Chancellor is doing in building alliances across the EU to ensure that British interests are properly protected and that Vickers is implemented?
That brings me to my final test: the impact on growth and the wider economy.
Madam Deputy Speaker (Dawn Primarolo): Order. I hope that the shadow Chancellor will be brief, given how much of the time allocation he has already taken.
Ed Balls: I shall put my questions briefly, Madam Deputy Speaker. I only regret that I cannot put these questions to the Chancellor because he has not turned up.
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We have consistently urged the Chancellor to take a swifter approach to competition and to have a growth objective for the new Financial Policy Committee. We and the CBI agree on that, but the Chancellor will not listen. The problem is that in those circumstances Vickers implementation could lead to a continuing impact on business lending at the expense of small businesses.
To conclude, we set three tests for Vickers, but on each one the Government are failing, causing uncertainty where we need confidence, lending and growth. They are failing to take the lead on reforms in the EU, and fudging and watering down proper taxpayer protection. We need a Chancellor who can do the economics, grip the detail and work full time on the job—someone who at least turns up in the House and answers questions on this vital issue.
Mr Hoban: The shadow Chancellor was the Minister who stood by when bank balance sheets ballooned and banks took on these risks. He did nothing to tackle that problem. As the Governor of the Bank of England said in May:
“With the benefit of hindsight, we should have shouted from the rooftops that a system had been built in which banks were too important to fail, that banks had grown too quickly and borrowed too much, and that so-called ‘light-touch’ regulation hadn't prevented any of this.”
Only two politicians were quoted in the FSA’s report on the failure of RBS as champions of light-touch regulation—the shadow Chancellor and the former Prime Minister, the architects and cheerleaders of light-touch regulation at home and abroad. They should recognise the costs that the British Government and economy have borne as a consequence of banking failure— £140 billion between 2007 and 2009. We must recognise the need for a stable banking system to ensure stable and sustainable growth in the UK economy.
As Sir John Vickers proposed, we are ring-fencing retail banking, imposing the higher capital standards required by him and introducing a binding minimum leverage ratio on banks. The shadow Chancellor asked some questions in the mix of his lengthy contribution, but he did not apologise for his role in the banking crisis. However, I shall respond to his tests. First, we have achieved international agreement with our European partners to implement Vickers through capital requirements directive 4 and capital requirements regulation. We have achieved that goal and are working to introduce a binding leverage ratio with international partners. Vickers can, therefore, be implemented through the existing international regulatory framework.
The shadow Chancellor talked about a banking union. Banking union is a product of the requirement for fiscal union and will be needed to promote stability in the eurozone, but that will not flow through to non-eurozone EU member states—an important distinction to make. Banking union is about the sustainability of the eurozone, not the EU.
The shadow Chancellor asked about hedging. Sir John Vickers recognised the need to ensure that retail customers and small businesses could access the hedging products necessary to manage risk on their balance sheets. However, we have gone beyond Vickers in imposing higher and tighter standards on how derivatives can be managed by a ring-fenced bank.
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I have set out a clear programme of reform that responds to the mistakes of the previous Government and ensures a stable and sustainable banking system that underpins, not undermines, economic growth.
Mr Andrew Tyrie (Chichester) (Con): The White Paper just published contains an impact assessment, paragraph 104 of which makes clear a point that we heard in extensive evidence—that costs to small businesses will rise as a consequence of these proposals. We also heard evidence that the scale of the rise would depend on the Government’s decision on the design of the ring fence. They have now published a lead option for that design, so what is their estimate of the increased cost of these proposals to small business lending?
Mr Hoban: We have considered Sir John’s recommendations carefully, including the cost on banks, the economy and business, but we felt it was in the interest of business to ensure that a wider range of products could be sold within the ring fence, including complex ones such as derivatives. We set out, in our cost-benefit analysis, to look at the cost of the package as a whole, not to break it up into particular areas. I am confident, however, that we will have a more stable banking system in a position to lend to business on a more sustainable basis. Through these reforms, we hope to increase competition in the banking system, which is in the interests of small businesses and will help to improve competition on price. I think, therefore, that this is a good package for businesses and will ensure the stability of the economy.
Mr Andrew Love (Edmonton) (Lab/Co-op): Next Thursday, there will be a debate in the House on the mis-selling of derivative and hedging products to small businesses, yet the Minister has announced that these will be allowed inside the ring fence. His excuse is that there will be stricter regulation, but are these not high-risk products that should not be mixed up with deposits in retail banks?
Mr Hoban: The hon. Gentleman follows these matters carefully. I do not know whether he, like me, has a fixed-rate mortgage, but that is actually a form of derivative. These products are widely used and there is a need for them. It is in the interests of businesses that such products be within the ring fence—it will provide much more control over their sale—although it is important to supervise properly the conduct of the banks selling them. The Financial Conduct Authority is well placed to provide that supervision, and with the tougher powers we have given it, that supervision will apply not only to retail customers but to business customers.
Andrea Leadsom (South Northamptonshire) (Con): Does my hon. Friend think it amazing, as I do, that the Opposition seem to take no responsibility for the tripartite regulation system that led to the complete disaster we have seen? I congratulate him on working to ensure that such a lack of accountability never happens again. Does he agree, however, that more can and needs to be done on new competition in banking, particularly on access for new banking entrants? Will he continue to assess—I keep asking him this—bank account portability, because it would be a game changer in the banking sector?
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Mr Hoban: My hon. Friend, who is right to point out the lack of an apology from the Opposition for their role in the crisis, has persistently raised account portability. She will know that Sir John Vickers considered this matter in the report but opted for improvements to the switching process to make it easier and more straightforward for customers. It is important that we pursue that, although full account portability will be an option if the former does not prove effective. We also welcome the work that the FSA and the Bank of England are doing looking at the requirements on new entrants to the banking system to ensure that both the conduct and prudential requirements are appropriate and not disproportionate.
Mr David Winnick (Walsall North) (Lab): On banking reform, would it not have been appropriate to make at least some reference to the outright greed of those who head the banks or to the millions of pounds that some of them get each year? Why no such condemnation—or is it the case that this Tory-led Government could not care less? What is all this business about “We’re all in it together”? It does not appear so, does it?
Mr Hoban: The hon. Gentleman should reflect for a moment on what happened when his Government were in power. Bankers were able to take their bonuses in cash in the year they were paid, while Lord Mandelson said that he was “intensely relaxed” about the filthy rich. What we have done since we came to office is put in place the toughest and most transparent pay regime of a major financial centre and ensured that shareholders have a stronger voice over bank pay. We have tackled the problem, which the previous Government simply neglected and allowed to fester and develop, thereby contributing towards the crisis that we have seen in the banking sector.
Stephen Williams (Bristol West) (LD): Two of the core reasons why the Conservatives and the Liberal Democrats came together in coalition were to stabilise our public finances and to reform Britain’s broken banking sector. Our constituents tell us that they want more banks that specialise in lending to small and medium-sized businesses, as well as ethical providers, such as Triodos bank, which is based in my constituency. Will the Minister undertake to smooth the path through regulation for new entrants and also make it easier for people to move their money from existing banks to new providers?
Mr Hoban: My hon. Friend makes some important points. We need to make the regime easier when it comes to authorising banks, which is why the Bank and the FSA are looking at prudential and conduct requirements, to ensure that they are appropriate and not disproportionate, which is one of the criticisms that many potential new entrants make. However, he is also right that once we have new entrants to the market, they need to be able to attract business from other banks. We need to ensure that customers are able to switch their accounts more easily. An industry-led initiative will be launched later this year which will help with that, but it is also important that customers understand the costs of their accounts and are able to use that money to help them shop around and opt for better-quality or new providers, so that there is much more choice and diversity in the market.
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Jonathan Edwards (Carmarthen East and Dinefwr) (PC): Considering that the banks are directly responsible for the great recession that we have experienced since 2008, is the Minister not concerned that delaying the implementation of the reforms until 2019, as reported in the press today, will leave seven years for the so-called golden goose to hold a golden gun to the heads of ordinary working people and the real economy, and give ample time for the all-powerful financial lobby to water down the proposals?
Mr Hoban: What we have been clear about, following the Vickers proposals on the timing of implementation—Vickers suggested that the measures should be implemented by 2019—is that we are taking steps now to ensure that there is a framework in place, so that banks understand what the rules will be and can respond. Today’s White Paper is part of that, and we will produce a draft Bill later, which will be subject to pre-legislative scrutiny as well. There will therefore be a transparent process to ensure that we implement the proposals. The proposals that Sir John Vickers made, such as ring-fencing, are vital to ensure the stability of the banking system and the stability of the economy.
Mark Field (Cities of London and Westminster) (Con): In the 14 months since the publication of John Vickers’s interim report, which other major global financial centres have gone down the route of proposing either a ring fence along these lines or the gold-plating of capital requirements, which is also proposed, on top of Basel III, which was supposed to harmonise capital arrangements?
Mr Hoban: A number of countries have argued for the freedom to go further and impose higher capital surcharges—Switzerland is one and Sweden, which has introduced higher capital surcharges, is another. It is our responsibility to ensure that we protect the stability of the UK economy and the interests of the taxpayer, and respond to the structure of the banking system in the UK. Bank balance sheets in the UK are many times larger than our economy. We are much more exposed to risk. It is therefore right that we should take actions in the UK that help to protect the economy and the taxpayer, which is why we are introducing these proposals today.
Anas Sarwar (Glasgow Central) (Lab): The Scottish Finance Secretary and the Scottish First Minister have said that if Scotland were to become a separate country, the Bank of England would remain the lender of last resort, while UK regulatory authorities would still oversee Scottish institutions. Can the Minister tell us what representations the Government have received from the Scottish Government and whether he is aware of any other EU country that does not have its own central bank or regulatory regime?
Mr Hoban: The hon. Gentleman raises an interesting question. There are some important questions to be answered about how the banks would be regulated if Scotland were to become independent. As I made clear in my response to the shadow Chancellor, a fiscal union needs its own system of banking supervision and its own resolution arrangements, and it is hard to see quite how things would work for an independent Scotland.
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Mark Garnier (Wyre Forest) (Con): I am grateful to my hon. Friend for his statement today, and also for these measures, which go a long way in dealing with the “too big to fail” problem, and in some ways deal with the “too small to start” problem. He will be aware that in the last 100 years, only one ab initio banking licence has been granted. Part of the problem is a reluctance on the part of officials at the FSA to grant new banking licences. Will he look again at the issue of competition in the Prudential Regulatory Authority, in order to try to help challenger banks enter the marketplace?
Mr Hoban: My hon. Friend makes a good point. As I have said, the Bank and the FSA are looking at prudential and conduct requirements to ensure that they are proportionate. However, the other thing I would say is that the implicit guarantee enjoyed by our bigger banks distorts competition. Our reforms tackle that, helping to create a more level playing field for new entrants and enabling them to compete properly with established players.
Keith Vaz (Leicester East) (Lab): The Minister will know that four weeks ago today the liquidation of the largest bank to have gone bust in Britain—BCCI—was completed, after 21 years. The foundation of the system introduced by the last, Labour Government was the Bingham report. The first part has been published; the second part is still confidential. As far as I know, only successive Chancellors have read it. Has the Minister read the second, confidential part, and does he not think it is time to publish it, so that we can have a proper understanding of the reforms that he has set before the House today?
Mr Hoban: I know that the right hon. Gentleman has raised this matter on a number of occasions, and I am not going to give a different answer from those that I or the Chancellor have given before.
Steve Baker (Wycombe) (Con): I congratulate my hon. Friend on the measures relating to bail-in and depositor preference in particular. However, I am sure he will remember that under the last Government the FSA came under political pressure. Will his measures deal with that and ensure that, in future, banks are resolved under the rule of law?
Mr Hoban: It is important that independent regulators exist and that their independence is credible. Going back to the FSA’s report on the RBS failure, it was interesting that the FSA clearly came under sustained pressure from the shadow Chancellor and the then Prime Minister to have a light-touch regulatory system, and we have seen the consequence of that. It is important that there are clear rules to ensure that regulators act independently and that their regulation is seen to be credible. The shadow Chancellor should recognise that he got it wrong when he called for light-touch regulation and championed it throughout the world.
Sheila Gilmore (Edinburgh East) (Lab): Given the double-dip recession and the continuing fall in net lending to businesses, what exactly are the Minister’s reforms going to do to stimulate the economy? Is there not a risk that we are going for the stability of the graveyard?
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Mr Hoban: The hon. Lady makes an important point about getting the balance right, but let us not forget that the banking crisis cost this economy £140 billion between 2007 and 2009. An unstable banking sector costs the economy dear: it costs jobs, it costs tax revenues and it costs families. The important thing is to ensure that we get the banking system right, so that it is stable and promotes growth, rather than allowing banks to let loose, grow their balance sheets unconstrained and take on risks that they do not understand, which is what happened in the lead-up to the financial crisis, when the shadow Chancellor’s system of regulation was in full swing.
Thomas Docherty (Dunfermline and West Fife) (Lab): Where is the Chancellor, and at what point did he decide not to make the statement himself?
Mr Hoban: It has always been the case that I would make the statement today. This may come as news to the shadow Chancellor—it may be different from his experience when he was City Minister—but the Treasury is a team. We have worked together on these reforms, and it was always the intention that I would make today’s statement. The shadow Chancellor should not believe what he reads on Twitter.
Mr William Cash (Stone) (Con): Having invested so much time advocating EU jurisdiction over banking in the City, how are the Government going to protect the City of London both from that EU jurisdiction and from qualified majority voting?
Mr Hoban: I think it is very clear that the emerging debate about a banking union flows from the problems we are seeing in the eurozone. It is important that the banking union helps resolve some of the problems in the eurozone, but it is a consequence of having a single currency, not a consequence of having a single market. It is important for the eurozone to move ahead in dealing with its problems and strengthening the banking regime within it. It is also important for the future of the City to ensure that there are proper safeguards over the functioning of the single market.
Mr William Bain (Glasgow North East) (Lab): With a double-dip recession made in Downing street, bank lending having fallen for five consecutive quarters and businesses facing a shortfall of £190 billion in finance over the next decade, why are there no further proposals in the White Paper to diversify the range of banking institutions to make sure that finance gets into the real economy?
Mr Hoban: I do not know whether the hon. Gentleman has yet read the White Paper. If he had, he would have seen a section on competition that deals with encouraging diversity, making it easier for new entrants to come into the market and promoting switching. When the hon. Gentleman has read the White Paper, he might like to come back to me.
Greg Mulholland (Leeds North West) (LD):
One of the very important and positive aspects of the Government’s reforms has been transparency, particularly over pay and banking products. Will the Minister assure us that there will also be a move to ensure greater transparency
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over bank lending figures, as small business organisations, and indeed small businesses themselves, tell us that the new lending figures provided often include existing loans and are simply not honest?
Mr Hoban: My hon. Friend is right, and I think transparency plays a key role in holding the financial system to account. We need to make sure that data on lending is transparent, but we also need to focus on identifying other ways in which we can help small businesses. That is why the Government introduced the national loan guarantee scheme—to help support lending to new businesses. That scheme is working; it is making thousands of loans to small and medium-sized enterprises, which are benefiting from the lower interest rates that the scheme delivers. That is an important way to help businesses grow.
Ian Murray (Edinburgh South) (Lab): Why will the Treasury not agree to Opposition requests for the Vickers commission to implement a progress report on how the Government are doing with its recommendations? Is it because the Government are trying to water them down?
Mr Hoban: The process we are going to go through is a very transparent one. We have published a White Paper today, setting out clearly our response—our detailed response—to John Vickers’ recommendations. As I said earlier, we are going to publish a draft Bill, which will be subjected to pre-legislative scrutiny. We are being very transparent about how we are implementing Sir John Vickers’ recommendations. I hope that the hon. Gentleman will work with us and ensure that the recommendations get through, so that we remedy the mistakes of the past.
Richard Fuller (Bedford) (Con):
I welcome the Minister’s proposals for the long-term protection of depositors, but he will be aware that many of us are concerned about the supply of credit to businesses in our economy right now and the impact right now of these long-term proposals. What analysis has the Treasury made of the impact on credit from these proposals in the near term? May I suggest that the Minister continues to monitor
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the impact with more urgency so that the concerns that have been raised can be assuaged?
Mr Hoban: Strong banks that are in a position to lend to businesses are absolutely vital to the long-term future of our economy. We have seen that the mistakes of the past eventually catch up with people. They have led to a weakening of bank balance sheets, which are now being strengthened. We need not only strong banks, but schemes in place to sustain bank lending and to ensure a supply of credit to SMEs.
Matthew Hancock (West Suffolk) (Con): In the week we discovered that a plan put forward to the last Government to prevent the run on Northern Rock was ignored, I warmly welcome these proposals. How will the Minister ensure that as finance changes in the years ahead, the Vickers proposals to ensure separation will always stay up to date with new technology and new techniques?
Mr Hoban: My hon. Friend makes two important points. He is right to highlight Hector Sants’s comments this week about how the previous Government ignored his proposals, leading to a run on Northern Rock that triggered widespread financial instability. If his proposals had been listened to, we could have had more financial stability, which would have been to the benefit of the economy.
My hon. Friend is also right that finance changes. Part of the problem of the previous Government’s regime was that it did not keep pace with changes in the markets. The previous Government clearly did not understand what was going on in the banking sector, despite the many meetings between the City Minister and the banks, but I think the regime that we are putting in place is forward looking. We will have the Financial Policy Committee looking at emerging threats to financial stability, and both our introduction of the Vickers reforms and the rules of the Prudential Regulation Authority will help to ensure that the ring fence is kept up to date and meets not just the needs of business, but the need for a strong and stable economy.
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Points of Order
1.26 pm
Greg Mulholland (Leeds North West) (LD): On a point of order, Mr Speaker. I have raised previously the awful case of the Prenga family, with Fran Prenga in a Greek jail. To my astonishment yesterday, I discovered that MPs’ parliamentary offices cannot phone numbers abroad, so I was unable to phone embassy and consular staff in Greece, unable to contact the family and unable to speak to the office of Edward McMillan-Scott, MEP, who is assisting in this case. It is clearly an absurdity to have to get my constituency office to make calls that I need to make myself from London. Could this matter be addressed as a matter of urgency?
Mr Speaker: I am grateful to the hon. Gentleman for his point of order. The matter is one to be taken up with the director of Parliamentary Information and Communications Technology. I am happy to do so, and then refer back to the hon. Gentleman as quickly as I can. He has raised a pertinent point, which requires a timely response. I hope that will be to his satisfaction.
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Backbench Business
Mental Health
Mr Speaker: At this stage, there is no time limit on Back-Bench contributions. Let us see how it goes.
1.26 pm
Nicky Morgan (Loughborough) (Con): I beg to move,
That this House has considered the matter of mental health.
I am particularly grateful to all members, old and new, of the Backbench Business Committee for allocating time for this debate in the Chamber. The effort to secure the debate has been done jointly with my hon. Friend the Member for Broxbourne (Mr Walker), the chairman of the all-party group on mental health, which he has led so well, and with my hon. Friends the Members for Worthing West (Sir Peter Bottomley), for New Forest East (Dr Lewis) and for Halesowen and Rowley Regis (James Morris)—I hope I have pronounced that one correctly—and the hon. Members for Dagenham and Rainham (Jon Cruddas) and for Foyle (Mark Durkan).
We were quite clear when we put in our bid that we wanted a full debate on the Floor of the House. Why? It is at least four years, and probably slightly longer, since the general topic of mental health was debated in the Chamber. That is a long time, given that 25% of the population—one in four people—will experience a mental health problem at some point in their lives. Just imagine if this were a physical health condition and it had not been talked about by Members in the House of Commons other than in very specific ways such as Adjournment debates for a very long time.
Mental health comes at an economic and social cost to the UK economy of £105 billion a year, yet mental health has been a Cinderella service—poorly funded compared with other conditions and not spoken about nearly enough either inside or outside this House. It is the largest single cause of disability, with 23% of the disease burden of the NHS, yet the NHS spends only l1% of its budget on mental health problems.
Mr Kevan Jones (North Durham) (Lab): Does the hon. Lady agree that it is not only a matter of the effects on individual mental health because mental health issues can lead to physical disabilities, leading to extra costs to the NHS on top?
Nicky Morgan: I entirely agree with the hon. Gentleman. The Centre for Mental Health has shown that for a person who has a physical and a mental health condition, the costs of treatment are increased by 45%. Those are additional costs around mental health problems, which are often untreated initially and then have to be treated at a later stage, so the hon. Gentleman is absolutely right.
According to the Centre for Mental Health, only a quarter of people with mental health conditions—children as well as adults—receive any treatment. I have no reason to doubt that statistic, and I find it shocking that
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three quarters of people with mental health conditions are not being treated. We should ask ourselves why that is.
Recent figures have shown that depression alone is costing the economy £10 billion a year. As we all know, we do not have a lot of money to spend, so we should be working as hard as we can on preventive measures. One in every eight pounds spent on dealing with long-term conditions is linked to poor mental health, which equates to between £8 billion and £13 billion of NHS spending each year.
I welcome the Health and Social Care Act 2012. I hope that today’s debate will be conducted on pretty non-partisan terms, but I realise that that may strike Opposition Members as a controversial comment. I welcome the opportunities that the Act offers for the commissioning of mental health services. I spoke in the Third Reading debate, and I especially welcomed the Government’s acceptance of an amendment tabled in the other place to ensure parity between physical and mental health. Although those are only words in a Bill, they are very important words, and they send a very clear signal not only to sufferers from mental health conditions and their families, but to those working in the NHS. I hope that, in his annual mandate to the national commissioning board, the Secretary of State will insist that the board prioritise mental health.
How are we to achieve parity between physical and mental health conditions? The question is about money, certainly, but it is also about awareness. Confessing to having a mental health condition carries far too much stigma. That is part of the reason for our wish to hold a debate on the Floor of the House. If we do not start to talk about mental health in this place, and encourage others to talk about it, how can we expect to de-stigmatise mental health conditions and enable people to confront their problems?
I find it interesting that, when I was preparing for the debate, a few people who had initially said to me “Yes, go ahead, mention my name” came back after thinking about it for a couple of days and said “Actually, I would rather you didn’t, because I have not told my employer,” or “I have not told all my friends and my family.” It is clear that mental health conditions still carry a considerable stigma. Admitting to having been sectioned is traumatic, especially when the information appears on Criminal Records Bureau checks connected with job applications.
I welcome the work of Time to Change, which has been funded partly by the Department of Health as well as by Comic Relief. I also welcome the Sunday Express campaign on mental health. However, the de-stigmatisation of mental health conditions is down to all of us, and it is especially important for those of us who are employers not to discriminate against people who may be working for us and who tell us that they have a mental health condition. I hope that today’s debate will constitute another firm step on the path to ensuring that mental health conditions are de-stigmatised, because I think that without that de-stigmatisation, successful treatment will be very hard for a person to achieve.
We asked for today’s debate to be kept deliberately general, so that Members in all parts of the House could raise many different issues on behalf of their constituents and, perhaps, themselves or their families as well as looking at the mental health policy landscape. Mental ill health is no respecter of age or background.
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It can strike anyone, often very unexpectedly. That includes people in senior positions such as Members of Parliament, company directors and school governors. I am sure that my hon. Friend the Member for Croydon Central (Gavin Barwell) will refer to the private Member’s Bill that he will be presenting, which would end discrimination against people in such positions who have mental health conditions.
I expect that during today’s debate we shall hear about new mums with post-natal depression. For them, a time of life that should be one of the happiest is often one of the most difficult. I welcome the recent Government announcement that health visitors will be properly trained to recognise signs of post-natal depression, which I think was long overdue. I expect that we shall also hear about veterans from our armed forces who suffer from mental health conditions, and about older people who suffer from dementia. Particular issues affect our black and ethnic minority communities, as well as those who find themselves in the criminal justice system. I am sure that we shall hear from the Minister abut the Government’s widely welcomed framework document “No health without mental health”, which was published last year. We now await the detailed implementation plan on which the Department of Health is working alongside leading mental health charities.
I want to talk, very briefly—I have noted Mr Speaker’s strictures about time limits—about three specific matters: listening to patients, integrated care, and the wider mental health well-being landscape. We made it clear during the passage of the Health and Social Care Act that one of the developments that we wanted to see, as a Government, was “No decision about me without me.” That means patients having a voice in their care. It seems to me from my discussions with those in the mental health system who have been sufferers that once the initial crisis has been dealt with, they tend to want choice and involvement in their treatment. They are facing a lifetime condition. They will have to self-medicate, look after themselves and identify the point at which they may be deteriorating or potentially reaching crisis point for years and years to come. They want a voice. They want to be heard by the health care professionals, and I think that it is up to us as a Government to help them to achieve that.
John Pugh (Southport) (LD): The hon. Lady has just said that people who suffer from mental health problems have a lifelong condition. I think that many people have an occasional mental health problem.
Nicky Morgan: I am not sure that I entirely agree with the hon. Gentleman. I agree with him that people often enter the system at a time of crisis and experience a single episode, but others who experience episodes will get better. For years they may have no problems at all. The hon. Gentleman shakes his head, but I can tell him on the basis of the experience of constituents and family members that it is possible to go in and out of the system. One of the hardest things for people to accept when they are diagnosed with a mental health condition is that they will be on drugs for years and years. That is often difficult for people to admit, particularly when they are striking up a new relationship or working for a new employer. I think that that is why people want to have a voice in the way in which they are treated.
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According to Mind, people are three times as likely to be satisfied with their treatment if they are presented with a choice of treatments, and failure to stay on medication is the main cause of relapses, when people often have to re-enter the system at a time of crisis. There is a need to work with and trust health professionals. According to a recent study by the university of Kent,
“Low levels of trust between mental health patients and professionals can lead to poor communication which generates negative outcomes for patients, including a further undermining of trust”,
“trust can play a significant role in facilitating service users’ initial and ongoing engagement with services, the openness of their communication, and the level of co-operation with, and outcomes from, treatment or medication.”
In 2009, a mental heath in-patient survey by the Care Quality Commission revealed that in some mental health trusts as few as 40% of people diagnosed with schizophrenia felt that they were involved as much as they wanted to be in decisions about their care and treatment. I am no health professional—I hope that some Members who are health professionals will speak later this afternoon—but what people have said to me suggests that medication is not always the answer, at least in the long term. Research by Platform 51 has found that a quarter of women have been on anti-depressants for 10 years or more, that half of women on anti-depressants were not offered alternatives at the time of prescription, and that a quarter of women on antidepressants have waited a year or more for a review of their medication
I welcome the Government’s investment of £400 million in treatments under the improving access to psychological therapies programme. I should add, to be fair, that that builds on announcements made by the last Government. I also commend the report by the Centre for Social Justice on talking therapies, which calls for a broadening of therapies. Every patient is different, and patients will respond differently to different medications and therapies. Mental health patients must have real choice, and I think that Any Qualified Provider and Payment by Results must be extended to them in the way in which they are being extended to patients with physical health conditions. We must also ensure that patients’ voices are heard within the management structures of both clinical commissioning groups and health and wellbeing boards, whose job it is to hold services to account for the care that they are giving.
I expect that Members will refer to integrated care: the need for all services to work together. Poor mental health has an impact on every area of Government policy: health care, benefits, housing and debt, social exclusion, business and employment, criminal justice and education, to name but a few. One person with a mental health condition may need help from many different agencies, but too often care is not joined up, and each agency deals with its own bit and passes the person on. Sometimes there is no follow-up, and the person is lost in the system.
In a 2011 survey, 45% of people contacted by Mind said that they had been given eight or more assessments by different agencies in a single year. YoungMinds, which campaigns on behalf of children and young people with mental health conditions, has called for one worker to be allotted to each child needing support for
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a mental health condition, so that children can avoid multiple assessments and need not re-tell their story each time they see a new person in the system. However, there must be a clear care pathway, whatever the point at which access is gained to the mental health system.
The other thing patients are calling for is the ability to self-refer. We need to do all we can to prevent people from reaching crisis point, and often it is patients themselves who are best able to tell when they are about to reach that point. My West Leicestershire clinical commissioning group is developing an acute care pathway in partnership with Leicestershire Partnership NHS Trust. It plans to replace the many and varied access routes to secondary care and mental health services with a single access point, in order to provide speedy access at times of greatest need. That move has come out of both patient and GP feedback.
Mr Robert Buckland (South Swindon) (Con): I congratulate my hon. Friend on securing this debate, and I am particularly interested in the proposed single access point for services. That could be useful not only for acute services, but for non-acute services and well-being provision. Does my hon. Friend agree that well-being provision is an important part of mental health provision?
Nicky Morgan: My hon. Friend is absolutely right, and I shall talk about well-being shortly. We often talk about these subjects in very negative ways. If we all talk about our mental well-being, and are regularly asked about it when we see our GPs, that will help a lot to de-stigmatise mental health issues.
I want to touch briefly on secondary care. One of the Sunday Express campaign demands is that all hospitals should be therapeutic environments where people with mental health problems feel safe and are treated with respect and have someone to talk to. In a debate in this House last November, I mentioned patients who abscond from secondary care units, and in particular the tragic case of my constituent Kirsty Brookes, who was able to escape from a unit in Leicester and subsequently hanged herself. I am sure the Minister will remember that debate, and our discussion of the definition of absconding.
The Care Quality Commission has published its first report on absconding levels, and I welcome that, but the picture in respect of absconding and escape numbers is still unclear. The numbers provided in this first CQC report need to be broken down further, therefore, but the report showed that in the year in question—2009-10, I think—there were 4,321 incidents of absence without leave from secondary care. Some of them were, of course, far more serious than others; some will have involved a person missing a bus on the way back to the unit, while others might have ended in tragic circumstances. I make this point not to beat up on secondary care providers and health providers generally, but we must know the scale of a problem before we can begin to tackle it.
The impact of the voluntary and community sector on mental health must not be forgotten either, and I hope Members will talk about that. The sector offers vital support, and it must be part of the commissioning landscape.
Jeremy Corbyn (Islington North) (Lab):
I congratulate the hon. Lady on securing this important debate. Many smaller voluntary sector organisations give a very good
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service and understand their communities. Under the commissioning process, however, they often lose out to very large enterprises—large charities and medical companies—that have no real understanding of the local community, particularly ethnic minority communities. Does the hon. Lady agree that the Minister needs to consider that issue further?
Nicky Morgan: I agree; that is an issue. The commissioning structures are being changed, with local GPs now deciding what care they want to buy and where they want to buy it from. I hope that change will allow them to explore the value of smaller organisations, which tend to know particularly well the people they are treating. Although such organisations might not have the clout of large organisations, they are often more successful in terms of patient care. I am sure the Minister has heard that point.
I want to thank one of my regular correspondents, Mike Crump of My Time, a community interest company based in the west midlands. He may well be in the Public Gallery for this debate. My Time provides evidence-based, culturally sensitive professional counselling and support services. He said to me that a great deal of many people’s recoveries
“is owed to therapies based on basic common sense not the miraculous powers of a tablet or the mysterious wonders of the medical profession.”
Let me turn briefly to policing. My chief constable in Leicestershire is also the Association of Chief Police Officers mental health lead. In Leicestershire in 2011-12 there were 444 detentions under section 136 of the Mental Health Act 1983, which gives powers to take a person to a place of safety. Leicestershire police deal with serious incidents involving mental health issues on a daily basis, and it has provided me with a snapshot of what happened on the jubilee weekend. From 8 pm one night to 7 am the next morning they dealt with 10 incidents in which mental health conditions or concerns were clearly prevalent. That night, police officers spent four hours with a man in hospital after he was detained under section 136. I therefore ask this question: are the police the right people to be dealing with such incidents?
I hope Members will talk about the criminal justice system, and the fact that nine out of every 10 prisoners have a mental health problem. The Government are investing more than £19 million this year in diversion services, but it is still taking too long to get prisoners out of prison and into secure hospitals.
Finally, I want to talk about the mental well-being landscape. All of us have mental health; it is just that some people’s is better than other people’s. We need to get to a situation where it is as normal to talk about our mental well-being as about our physical well-being.
Public health policy has a role to play. Local authority public health services are key in promoting good public health. I welcome the Leicestershire joint strategic needs assessment chapter on mental health, which was published recently. It makes it clear that mental health is important and says that it cannot be seen in isolation, as many factors contribute to mental ill-health, including the economic instability at present—which I am sure we will hear about this afternoon—and the welfare reform changes, such as asking people whether they are fit enough to go back to work. I think such questions need to be
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asked, but I thank my constituent Jo Gibbs, who recently brought me a letter outlining her concerns about these changes and the anxiety and pressure they are causing her and others.
Julie Hilling (Bolton West) (Lab): I congratulate the hon. Lady on securing this debate, and on her speech. On welfare reform, does she share my concern that people with mental health issues are being kicked off disability support allowance? Increasing numbers of people in that situation are coming to see me. Recently a constituent came to me who is bipolar on the Asperger’s spectrum and who scored zero in the assessment for that allowance.
Nicky Morgan: I thank the hon. Lady for her intervention. I am sure we will all have similar constituency cases. A survey by Mind found that most people with mental health problems want to work but may not be well enough. For some people, employment—the right employment with the right employer and the right support—is the right way forward once they are better. For other people, however, employment is not the answer. The hon. Lady is right that assessors have not always understood the mental health needs of certain people. The Government have tried to address that through the two Harrington reviews. The system is never going to be perfect. That is where Members of Parliament come in; we will be making arguments on behalf of our constituents. I understand the hon. Lady’s point, however. We need to do more, and we need to promote awareness of these issues.
Other aspects of modern life do not help, such as loneliness and isolation. We live in an ever busier world, but people lead more isolated lives. We must not forget the question of families either. Sometimes they can be the cause of a person’s problems, but at other times they can be the solution. I commend the Centre for Social Justice for its work and its report, “Completing the Revolution”, about the importance of families and how significant family breakdown can be in respect of mental health problems.
This is an important debate, but it is only one step along the path of giving mental health the priority that Members clearly feel is needed given the number of them present today. I look forward to hearing their views. We need to talk about mental health far more openly, and we need to make it much easier for people to find out information about how they can get help before they need it. It is too late when people reach crisis point.
I look forward to the no health without mental health framework being implemented. Talking must never stop, but we must now also start implementing. I thank everybody who has contacted me in the run-up to this debate and shared their often very personal stories about their experiences in the mental health system. The House is all too often known for Members shouting at each other. I hope today shows that we are about more than that, and I hope we can all agree with the motion before us, as mental health is a huge priority for Britain and for our constituents, whether they are sufferers or carers. Working together, we can come up with integrated care that responds to the needs of patients and gives our mental well-being the prominence it merits.
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1.50 pm
Mr Kevan Jones (North Durham) (Lab): I congratulate the hon. Member for Loughborough (Nicky Morgan) and the Backbench Business Committee on securing this debate, and I pay tribute to her very well-informed contribution. She is obviously a great champion for people who in many cases do not have a voice in the health system. Let us hope that by securing this debate we can give those people the voice they need, and not only, as she says, in the health service; we also need to get the message across to employers and others that mental health issues are not an inhibitor to a good and successful career and a fulfilled life. I shall discuss that in a moment.
I declare an interest as the president of my local Chester-le-Street Mind group. I have had an interest in mental health for a number of years. The hon. Lady mentioned the role of the voluntary sector. It plays a fantastic role, not only in promoting the issue of mental health but in delivering services. In some cases, these organisations are better vehicles for delivering this localised help than some of the larger companies referred to by my hon. Friend the Member for Islington North (Jeremy Corbyn), or even the NHS itself.
The hon. Lady said that one in four people could suffer from mental health problems in their lifetime. The hon. Member for Southport (John Pugh), speaking from the Lib Dem Front Bench, is both right and wrong in what he said. Some people do have mental health issues because of events in their life—crises happen and people can get over them in a short time—whereas others have long-term conditions that have to be lived with throughout their life, by way of drug treatment and other effective therapies, as the hon. Lady said. There is a big difference between those two situations. Anyone in this Chamber or any of their family members could suffer from short periods of mental health illness or be long-term sufferers. That is the important thing to get out of today’s debate.
We also need to address the cost, which the hon. Lady mentioned. I am thinking not only about the cost to the NHS, and the personal cost to individuals and their families, but about the cost to UK plc. I reiterate that mental health issues can affect anyone. I know general practitioners who have gone through periods of severe depression. I know one who works as a consultant cardiologist and is brilliant in his field but who lives with mental health issues, and has for many years. He has a very understanding employer and is very open about it. Let us not say that there are any boundaries in mental health, because there are not; these issues can affect anyone in society.
I wish to discuss two issues, one of which is the effect of funding on mental health. The other relates to the welfare reform changes, to which my hon. Friend the Member for Bolton West (Julie Hilling) referred. They are having a disproportionate impact on people with mental health issues. I accept the view of the hon. Member for Loughborough that we do not want to get into a party political debate, but there is unjoined-up thinking in some parts of the coalition’s policy. I must say that I saw exactly the same thing when I was a Minister, when one Department does something that has an effect on others, and it is sometimes difficult to get round those circles. However, local authorities in the north-east are clearly having to cut back on funding for
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this. Mind has said in the briefing note it sent to us for today that about 22% of its funding at the local level has been cut. That is a shame because, as I said, those organisations are sometimes the best at not only being advocates for local mental health services, but at providing care. In regions such as my own in the north-east, funding is vital for those organisations. When I talk to local mental health professionals and charities, I find that it is unfortunately a fact of life that economic conditions at the moment mean that the demand for services is increasing.
The hon. Member for Loughborough referred to the Health and Social Care Act 2012, and I agree with her that it does present some opportunities, if things are done properly. Chester-le-Street Mind, under the great leadership of Helen McCaughey and her husband, Charles, delivers a local therapy service, commissioned by the primary care trust, and it is great. It is carried out in the community, and that is the model that I like to see. The only concern I have, from talking to GPs over the years, is that although some of them are passionate about mental health and understand it, others do not. The challenge for the new commissioners is to take a bold step and say that some of these services can be delivered in the community by groups such as Chester-le-Street Mind and others. The Government might have to be aware of that nationally. As my hon. Friend the Member for Islington North said, this does not have to involve just large companies, because the approach I have described would be effective. That is my only concern: that although I know some very good GPs, including my own, who have a clear understanding of mental health issues, others are not very good at giving this appropriate priority—I am sure that the hon. Lady is aware of some of those. We are thus presented with both an opportunity and a risk.
The Minister of State, Department of Health (Mr Simon Burns): I am extremely grateful to the hon. Gentleman because he is making an extremely good point, but does he agree that, under the reforms and the new NHS, a crucial role will be played by the health and wellbeing boards, which are there to monitor and ensure that the local health needs of local communities are provided for?
Mr Jones: Yes, that is one of the key roles of those boards. Again, however, it will be important to ensure that we get the right people on those boards—for example, counsellors who really understand mental health. As the hon. Member for Loughborough said, people have empathy in respect of cancer, but do not quite understand mental health. I agree with the Minister that it is important that the boards are the counterweight to ensure that that happens, but I think that central Government also have to play a role in ensuring that it happens. As I say, we have some great opportunities here and the commissioned work that Chester-le-Street Mind delivers is excellent. In addition, it is cheap compared with some of the major contracts in terms of delivery, because it is delivered by well-trained professionals and by very committed and hard-working individuals in the community.
A lot of mental health charities also rely on charity funding from organisations. In the north-east this funding comes from, for example, institutions such as the Northern
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Rock Foundation, which has now been taken over by Virgin Money. There is real concern that as those sums contract, the money going into mental health services from those groups will also contract. We need to keep an eye on the situation to ensure that, be it through the lottery or through organisations such as the Northern Rock Foundation or the County Durham Community Foundation, where funds are limited because of the economic crisis, mental health gets its fair share of the funding available. I mean no disrespect when I say that people give happily to Guide Dogs for the Blind or to cancer charities, but it is very much more difficult to get a lot of people to recognise and give money to mental health charities, unless they have been through or had a family member who has been involved in mental health issues. We need to be wary of that, too.
I now wish to discuss the welfare benefit changes, which my hon. Friend the Member for Bolton West mentioned. I commend Mental Health North East, a very good group in the north-east that has interacted with the Department of Health. It is an umbrella group of mental health charities that not only campaigns for and raises awareness about mental health but delivers services to mental health charities and individuals. The organisation is run by a very dynamic chief executive, Lyn Boyd, and is made up of paid individuals and a large number of volunteers, many of whom have personal experience of mental health issues. They are very good advocates, not only ensuring that mental health is kept high on the political agenda but interacting very successfully with the Department of Health in consultations and so on.
One piece of work that that organisation has considered is on a matter that I have increasingly seen in my constituency surgeries. There are people with mental health issues who were on the old incapacity benefit and are now on the new employment and support allowance and who are, frankly, being treated appallingly. The way that is being done is costing the Government more money in the long term. I know that it is not the direct responsibility of the Department of Health, but some thought needs to go into how we deal with the work test for people with mental health illnesses. I am one of the first to recognise that, as most of the professionals say, working is good for people’s mental health; it is important to say that. However, we must recognise that certain people will have difficulties with that. If we are to get people with mental health problems into work, we must ensure that the pathway is a little more sympathetic than the one we have at the moment.
Another massive problem is the work needed with employers. If employers are going to take on people with mental health issues, they will have to be very understanding to cope with those individuals.
Jeremy Corbyn: Many of those who are taken for work-related interviews by Atos are declared fit for work, only to win an appeal to show that they are not. On many occasions, the levels of stress they have been through in going for the interview, failing it and winning an appeal are very detrimental to their health. Does my hon. Friend agree that the Department must be far more sensitive about that and think a lot more before it starts to call people in for these interviews?
Mr Jones: I totally agree and I shall give some examples of that in a minute.
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We must try to get a system in which employers, even in these tight economic circumstances, understand the mental health issues and can make adaptations. Whether we support employers who take people with mental health issues on for a certain period or whether we do other things, we need to think it out a bit more than it is at the moment.
Nicky Morgan: One statistic that I did not use in my speech was that only 1% of the access to work funding, which employers can use to help to smooth someone’s path back into employment, is used for mental health facilities. It could be used for counselling or support workers, but only 1% is spent on such provision in the context of the prevalence of mental health issues in the general population.
Mr Jones: The hon. Lady makes an important point that should be considered. That is where we need to join up the two relevant Departments.
Mental Health North East has carried out a survey and I thank that organisation and Derwentside citizen’s advice bureau for the examples I am going to use. Like the hon. Member for Loughborough, I asked whether I could use names. One person said that I could, but late last night she rang me to say no. I am sure that people will understand why I use letters to refer to these individuals rather than their names.
The first case is that of Mr A, a 50-year-old man who lives alone and received ESA. He suffers from depression, anxiety, agoraphobia and anger issues. Despite the support he is getting and the drugs that he is taking, he was called by Atos to a work-related interview. He got no points at all even though he finds it very strange to go outside the house, let alone to interact with people. He decided to appeal and attended the appeal. There is a huge backlog in the appeals system that is adding to people’s anxiety as they are having to wait a long time, and the pressure on citizen’s advice bureaux and local welfare rights organisations to support those appeals is creating a crisis in some of them. When I give some of these examples, Mr Speaker, you will see that they should never have gone to appeal in the first place.
This case was very interesting. Mr A turned up at the appeal, which, as my hon. Friend the Member for Islington North mentioned earlier, caused him huge stress as he thought he was going to lose. He turned up in the afternoon, and his appeal had been heard that morning without his being present and his award had been granted on the basis of the medical evidence. If the appeal hearing could do that, why could Atos not do so? The reason is that Atos is not taking medical evidence into account at all.
The second individual is from Stanley in my constituency and I have known this young lady since she was in her early 20s.
Sir Peter Bottomley (Worthing West) (Con): In the hon. Gentleman’s example, was Atos setting its own procedures or was it following the instructions under the contract?
Mr Jones:
Having seen the form, I think it was according to the contract, and this is where things need tweaking. We need a special form for people with mental
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health issues, rather than using the generic form for people with other disabilities, too. That is the important point that needs to change.
Miss B, as I will call her, is 36 and a single parent who lives in Stanley in my constituency. She has a very supportive family and receives huge support from her local Sure Start and her local community mental health team. She has been unemployed, suffers from bipolar depression and is on a cocktail of medication. Although everyone has been told not to contact her directly but to contact her mother, Atos contacted her directly. She lives independently just down the street from her mother, which is good, but everyone has been told to contact the mother because she does not quite understand. When Atos contacted her with a telephone request for interview, according to her mother it sent her into an absolute panic. If her neighbour had not been there to help her, it would have caused huge problems.
Miss B went to the interview and failed it, getting no points. She is now having panic attacks, she has had episodes where she has felt suicidal, and without support her child would have been taken into care. She was nearly hospitalised because of the stress. She has now had to wait upwards of eight months for her appeal to be heard, but in the meantime, and not just because of the ESA, her housing benefit has been stopped so she is in debt. It is one thing after another, which is not what someone with severe mental health illness needs and that is why we must refine the system. That woman has been waiting for an appeal for eight months now and, knowing the case as I do, I have no doubt that she will win.
My final example is Mr J, a 52-year-old who suffers from mental health illness, partly as a result of his separation from his partner a few years ago. He suffers from very severe depression and is on antidepressants. He has tried to help himself by going to cognitive behavioural therapy sessions. In January 2012, the Department for Work and Pensions wrote to ask him to attend an Atos interview, which caused him to withdraw from his treatment programme. That was not good for him. Very insensitively, Atos then rang him on Christmas eve to organise the appointment. Again, despite the fact that a lot of medical evidence was presented, Atos did not take any of it into account.
There is another thing that Atos is getting completely wrong, or at least has an inconsistent approach to. Mr J took his son, who is one of his key supporters, along with him and asked whether he could make representations on his behalf. He was told no. In other cases, people have taken their community psychiatric nurses with them only for them to be told to sit outside the interview while the individual goes in. Atos is being inconsistent in its approach and is clearly not taking on board any of the medical evidence that is put forward. Mr J appealed and, as in the first case I cited, the appeal went through on the basis that the medical evidence presented was good enough. What is Atos doing? What concerns me about these cases is the cost not just to the individual but to the health service and the local NHS.
Let me highlight the findings of the survey I mentioned and read some quotes from it. In response to a question about whether medical evidence was taken into account, someone said that it was “not even looked at.” Another response was:
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“Not at all and there was a great deal including an advocate (myself) attending the Medical. Nothing that I said”
seemed to make a difference. Yet another:
“Generally, clients feel that mental health is not taken into consideration”
and is not being focused in the way that physical disabilities are.
“Most clients believed that their own medical evidence had been completely disregarded”
at the interviews they attended. Another issue that was commonly raised was how little time it took—less than 15 minutes in most cases.
Question 6 asked about the impact on individuals. Let me quote some of the answers directly:
“Despair. Resignment to the cruelty dished out”
“Very distressed, anxious, scared”.
“Very stressed, confused, angry and frightened as you can imagine, these people are already existing below the poverty line”
and this increases stress levels.
Judging by those examples, the system needs to be changed. It is inefficient, it is causing huge problems for individuals, and is also costing the system more. What we need to do, possibly through the Department for Work and Pensions and the Department of Health, is come up with a specific work test for people with mental health issues, and recognise that individuals have to be supported.
Now I am going to throw my notes away—I thought long and hard last night about whether to do this—and talk about my own mental health problems. 1n 1996, I suffered quite a deep depression related to work and other things going on in my life. This is the first time I have spoken about this. Indeed, some people in my family do not know about what I am going to talk about today. Like a lot of men, I tried to deal with it myself—you do not talk to people. I hope you realise, Mr Speaker, that what I am saying is very difficult for me.
I have thought very long and hard about this and did not actually decide to do this until I just put my notes down. It is hard, because you do not always recognise the symptoms. It creeps up very slowly. Also, we in politics tend to think that if we admit to fault or failure we will be looked on disparagingly by the electorate and our peers. Whether my having made this admission will mean that the possibility of any future ministerial career is blighted for ever for me, I do not know. I was a Minister in the previous Government and I think that most people on both sides of the House thought I did a reasonable job.
We have to talk about mental health issues in this place, including people in the House who have personal experience of it. As I have said, I thought long and hard last night about doing this and I did not come to a decision until I put my notes down just now. Whether it affects how people view me, I do not know; and frankly I do not care because if it helps other people who have depression or who have suffered from it in the past, then, good.
Politics is a rough old game, and I have no problem with that. Indeed, I am, perhaps, one of the roughest at times, but having to admit that you need help sometimes is not a sign of weakness. I also want to say to you, Mr Speaker, that we need to do more here to support Members with mental health issues. In terms of
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occupational health, we have an excellent individual in Dr Madan, who understands mental health issues very well. I know of only one other Member who has suffered from mental health problems because a colleague on the Labour Benches has spoken to me about her mental health issues and depression, but it is important to get the message across to individuals that if they are having problems they can go and see Dr Madan and her team.
May I also highlight to you, Mr Speaker, the problems that Dr Madan has with getting funding for treatment afterwards? The hon. Member for Loughborough mentioned drugs, and they are part of the answer, but they were not the solution for me. Things like cognitive behavioural therapy can be far more effective. As I learned over many years, it is about how you think. Dr Madan raised an issue with me regarding an individual for whom she was trying to get funding, but the House authorities were not prepared to do it. If she comes to you, Mr Speaker, regarding any Member who wishes to have mental health support you have to say yes because it is not easy for Members of Parliament to go to their own GP or local community to talk about these issues. Sometimes, it is perhaps better for them to have treatment and find solutions here rather than in their constituency. That is a plea to you, Mr Speaker, and I would be grateful if you took that on board.
As I have said, I do not know whether I have done the right thing. Perhaps I will go home tonight and think I have not, but I think I have. I hope that it does not change anyone’s view of me. Most people might think, “Christ, if it can happen to him, it might happen to anybody.” On that note, let me put on record my thanks for the opportunity to debate this issue. Let us go out and champion this issue.
Finally, let me say to every hon. Member present and to those who are not present that although being an MP is a great privilege—I have always thought that; it is a great thing that I love—it also has its stresses. Unless someone has done it, they do not know what those stresses can be personally, in terms of family, and in terms of what is expected of us in the modern technological age. A little more understanding from some parts of the media and some constituents about the pressures on the modern-day MP would be very valuable.
2.16 pm
Mr Charles Walker (Broxbourne) (Con): It is absolutely fantastic to follow the hon. Member for North Durham (Mr Jones). I was a researcher here in the early 1990s and a few Members present were here at that time. They will remember the debates about homosexuality. There were some discriminations, as there still are, in relation to homosexuality, and people were beginning to feel very uncomfortable about that. Many colleagues came to this place to take part in those debates, and they would say, “These discriminations against homosexuals are disgraceful, but I am not gay myself.” They did not want to be perceived as gay because they had an interest in those matters.
I am delighted to say that I have been a practising fruitcake for 31 years. It was 31 years ago at St John’s Wood tube station—I remember it vividly—that I was visited by obsessive compulsive disorder. Over the past 31 years, it has played a fairly significant part in my life. On occasions it is manageable and on occasions it becomes quite difficult. It takes one to some quite dark
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places. I operate to the rule of four, so I have to do everything in evens. I have to wash my hands four times and I have to go in and out of a room four times. My wife and children often say I resemble an extra from “Riverdance” as I bounce in and out of a room, switching lights off four times. Woe betide me if I switch off a light five times because then I have to do it another three times. Counting becomes very important.
I leave crisp and biscuit packets around the house because if I go near a bin, my word, I have to wash my hands on numerous occasions. There has to be an upside to a mental health problem. I thought that the upside would be that I would not get colds, because apparently if you wash your hands a lot, you don’t get colds, but I wash my hands hundreds of times a day and I get extremely cheesed off when I end up with a heavy cold.
OCD is like internal Tourette’s: sometimes it is benign and often it can be malevolent. It is like someone inside one’s head just banging away. One is constantly striking deals with oneself. Sometimes these are quite ridiculous and on some occasions they can be rather depressing and serious. I have been pretty healthy for five years but just when you let your guard down this aggressive friend comes and smacks you right in the face. I was on holiday recently and I took a beautiful photograph of my son carrying a fishing rod—hon. Members may know that I love fishing. There was my beautiful son carrying a fishing rod, I was glowing with pride and then the voice started, “If you don’t get rid of that photograph, your child will die.” You fight those voices for a couple or three hours and you know that you really should not give into them because they should not be there and it ain’t going to happen, but in the end, you ain’t going to risk your child, so you give into the voices and then feels pretty miserable about life.
But hey, there are amusing times as well. I do not feel particularly sorry for myself, because my skirmish with mental health is minor. There are people who live with appalling mental health problems day in, day out, which is why I when I became an MP, I regarded it as a wonderful opportunity to try to help them. I hope that I have an insight into some of their pain and agony and the battles that they go through on a daily basis. Many people are frightened and feel excluded.
My first year and a half in Parliament was absolutely appalling. It was very, very difficult. My constituents thought that I was a jolly fellow—that is how I came across—but I remember sitting in my office going through my post. A book arrived with a letter saying, “Managing your Tourette’s”. I thought, “Oh my word, someone has spotted me on television. I’m done for. They’ve sent me a book and I’ll be outed in the newspapers: ‘Walker’s a loony’”. My constituents will turn their backs on me, my association will throw its hands in the air, and my children will be chased through the playground.” I sat in cold terror for 10 minutes, wondering how I would navigate my way through this. I then picked up the letter and realised that it was a circular that had gone to all 650 MPs, so I took great comfort from the fact that probably 50 others were having the same emotions as me.
We can talk about medical solutions to mental health problems, and of course medicine has a part to play. In reality, however, society has the biggest part to play. This is society’s problem, and we need to step back from
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our own prejudices, park them and embrace people with mental health problems. You only get one chance at life. You get about 80 years-ish. If you have severe mental health problems, you get about 65. Can you imagine going through your whole life feeling miserable, excluded, discriminated against, with little hope? I cannot. I have a wonderful vocation, I have a loving family, and I have a comfortable lifestyle, so I know, even when things are bad, they will get better, but a lot of people are not in that position, and we need to reach out to them.
I am really excited about the speech by the hon. Member for North Durham—I am very excited about that—and I am excited about the fact that my hon. Friend the Member for Loughborough (Nicky Morgan) secured this debate. We are making progress and moving in the right direction. We will hear from my hon. Friend the Member for Croydon Central (Gavin Barwell) in a few moments—or hours—about his private Member’s Bill. Many colleagues in the House are taking part in the debate. I think that some colleagues would like to be here but, again, if they are here discussing mental health, some people might feel that they have a problem. Look, it is a not a problem, it really is not: let’s get over it guys, and move on.
Media reporting has improved and we do not often see headlines such as “Frank Luno”, which was totally indefensible. The media are beginning to get on board, because there are many people in the media who suffer from mental health problems. As the hon. Member for North Durham alluded to at the beginning of his speech, who are these people out there? They are doctors, nurses, teachers and soldiers; they are all around us. Why would the hon. Gentleman’s constituents think any differently of him now than they did 20 minutes ago? In fact, they will respect him a great deal more. Why would my constituents think any differently of me now than they did 10 minutes ago? Those who disliked me will continue to dislike me; those who like me will continue to like me; and those who were slightly agonistic could go either way.
Here we are, having a great, great debate. The all-party group on mental health is going from strength to strength and, for the first time, I am feeling really positive and very happy. I am not going to speak for much longer, but I want to say two things. We need to sort out independent mental health advocacy for people who face incarceration or are on community treatment orders. Access to representation is patchy across the country, and we need to sort that out, because we cannot lock up people who do not receive proper advocacy or constrain their liberties without proper advocacy.
We also need to address Criminal Records Bureau checks under the heading “Any other relevant information” that are entirely at the discretion of the chief constable. I am aware of a number of people who have had mental health problems and have been detained for a short while. The police became involved, because they took those individuals into detention or to hospital. They go for a job perhaps as a counsellor or working in the charitable sector. They have a clean record but under “Any other relevant information” the chief constable can say, “We are aware that this person was detained for a mental health problem at this institution. We are not aware that they are a threat to adults or children.” That
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is that. That is the end of the matter, because we recognise that there is stigma and discrimination. I am afraid that in our ultra risk-averse world, that is a career death sentence for those people. We need to sort that out.
I join the hon. Member for North Durham in saying that I am not frightened any more. Like him, I am pretty middle-aged, and I do not care what people think of me any more. When people come up to me and say, “Mr Walker, we think you an absolute rotter and so-and-so”, with OCD, I would probably have said a lot worse to myself 20 minutes earlier. It is not such a big deal. I am not frightened any more. It is a really good place to be, and we need to ensure that many hundreds of thousands can be in that place as well. Not being frightened is a really good thing. Hon. Gentlemen, hon. Ladies and friends: rock and roll, as they say. Thank you.
2.26 pm
Jim Shannon (Strangford) (DUP): I am privileged to be in the Chamber to hear some of the speeches that have been made, including those by the hon. Members for Broxbourne (Mr Walker) and for North Durham (Mr Jones). It is a great privilege to hear what they said. I congratulate the hon. Member for Loughborough (Nicky Morgan) on raising the matter in the Chamber. She said that everyone has mental health issues; I suppose it is a matter of how they deal with that and control it. We all have a breaking point. I hope that I never reach that breaking point, and that others do not do so either.
As an elected representative, in my interaction with constituents in my office, I see very clearly how people deal with depression. As the hon. Member for Strangford, I wish to express views on behalf of my constituents, ever mindful of the fact that health in Northern Ireland is a devolved matter. However, the debate is on mental health generally, so the issues in Northern Ireland are every bit as relevant as those in Broxbourne, North Durham, Loughborough and anywhere else in the United Kingdom. Every day I deal with those issues, whether through employment and support allowance appeals or disability living allowance appeals, or by interacting with people and the way in which they deal with their benefits.
An issue that has been highlighted in the Chamber is the difficulties that can arise. That was an issue before the economic downturn, but it is a bigger issue today, because people find it harder to deal with the economic and financial realities that face them, which compounds their problems. In all honesty, over the past year or 18 months, I have seen greater need in people who suffer from depression, as they have had to deal with issues with which they have never had to deal before. We have debated many great issues in the Chamber in the two years in which I have been an MP, but this issue is certainly one of the most important.
I want to deal with two issues. I want to talk about mental health from the perspective of Northern Ireland, and I also want to touch on an issue the hon. Member for Loughborough mentioned when she talked about the armed forces. There are problems for our soldiers and service personnel returning from the battlefield, whether Afghanistan or Iraq, because their memories of those conflicts do not finish when they get off the plane or boat after returning home; they are still with them many years after the conflict. I feel strongly about that for those who returned from both Iraq and Afghanistan.
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Good mental health should be a priority for us all, as every Member who has spoken so far has indicated. In Northern Ireland we have also made it a priority. However, Northern Ireland—I say this with respect—has been underfunded for many years, owing to direct Government reasons and others. The figures show that mental health is a greater issue in Northern Ireland than it is in other parts of the United Kingdom. People would say that that is perhaps because of the 30 years of the troubles, which I think is probably true. When someone is under pressure or stress and worried about whether they will live or die, they turn to drink, drugs or other things, and that affects their lifestyle. Ultimately, a great many people in Northern Ireland suffer from depression and mental health issues because of our country’s past. I am glad to say that we have moved on. We now have a partnership Government and we are working together to ensure that there is a future for everyone, and that in the future there is a lessened threat of terrorism.
The British Medical Association in Northern Ireland has done significant research on mental health there. When the hon. Member for Loughborough introduced the debate she mentioned a number of the points that are also in the BMA’s report, so I could not help but wonder whether she had perhaps seen the same report. It contained a number of points that she referred to and commented on. I think that the reason those points are so similar to what she said is that the same issues are just as relevant in Northern Ireland as they are in Loughborough and the rest of the United Kingdom.
I would like to touch on how we can improve the situation. I know that the Minister will have a detailed and helpful response to the debate. To start with, it is a taboo subject. I think that the Government and policy makers must strive to ensure that the stigma, which Members have talked about, and the clear discrimination and fear that surround mental health are eliminated or addressed by focusing on promotion, education, prevention and early intervention. Those are the four headlines the BMA puts forward in its suggestions. There is clearly a work force planning problem that, in some occasions, occurs simply because of reductions in staffing levels. There are a number of things we need to do, and perhaps the Minister, when he responds, can tell us how the issue of mental health will work within the staffing restrictions and assure us that that concern will be taken on board.
The Northern Ireland Executive’s programme for government made a commitment to work for a healthier people and identified mental health as a priority. It also set out targets to try to address the issues. The person who suffers from mental health problems is only part of the problem. When a constituent with mental health problems comes to my office, as they do to the offices of other Members, there is not just one person sitting in a chair in front of me, because they are usually accompanied by someone else; there is a family circle, children, mums and dads and everyone involved. While one person might suffer from mental health problems, half a dozen people could be affected by the ripples.
I am also concerned about teenagers who suffer from depression. Between 10% and 20% of our teenagers will suffer from depression at some point in that short period of their life. I believe that there has to be recognition of mental illnesses, notably depression, and it means that we need to look beyond good mental health and at
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preventing mental health problems and ensuring early intervention. Many personal issues affect mental health, including drink, drugs, working conditions, homelessness, poverty, unemployment and risk-taking behaviour, whether smoking or unsafe sex, and those issues affect many of the people who come to my office with these problems.
Let us address these problems first by strengthening individuals, by addressing emotional resilience and by promoting self-esteem, life skills, coping skills and communication skills. We also have to strengthen communities. Those are the issues I feel are important. That means addressing the issue of social inclusion, improving neighbourhood environments, which make a difference. In relation to teenagers, we also have to try to address the anti-bullying strategies in schools. Those are important because bullying is one of the things that lead to young people having these depression issues.
We also have to reduce the structural barriers to mental health, which means access to education and meaningful employment. I know that that everyone will agree with that, but at the end of the day we need to have a strategy in place to address mental health issues, and that is what we are seeking to do through this debate. We all agree that there is absolutely no doubt that we all support the issue and the vulnerable people affected, people who we meet every day and who need real help.
Suicide in the community is a great worry for us all as elected representatives. Every one of us will have dealt with families, with people whom we know personally or with people from families that we know personally who have lost loved ones—who took their own lives because they felt that there was no way forward. They were coming off the back of terrible depression or terrible pressure, and did not know where they could go next.
Mr Kevan Jones: We have been talking about the voluntary sector, and in my constituency there is a very good organisation, which also came about as a result of a personal tragedy for the individual—a woman called Shirley Smith, who runs If U Care Share. Her 19-year-old son died, and it is about young people and talking about those issues. She goes into schools, youth groups and football clubs to do so. Does the hon. Gentleman think we should have a national strategy on that to ensure that it is part of the curriculum as well?
Jim Shannon: Yes, I do. When a constituent of mine died in a car accident on a Sunday night, I went to her house on the Monday night, and her father just wanted to speak and to talk about his daughter. That is the issue. On many occasions, it is just a matter of having someone to talk to, someone who can lend a sympathetic ear when it is needed most, so I wholeheartedly agree with the hon. Gentleman on that matter.
Back in 2005, the then Secretary of State for Northern Ireland, who had some responsibility for health, the right hon. Member for St Helens South and Whiston (Mr Woodward), set up a task force to develop a suicide prevention strategy for Northern Ireland. It is paying some dividends in relation to a decrease in the number of suicides, but the number is still at a very high level.
Other Members have touched on dementia and Alzheimer’s, and after wearing my hat as a councillor for 26 years and as an Assembly Member for 12 years, before being privileged to enter this House, I must note
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that the number of people with Alzheimer’s and dementia is greater today than ever before. I do not know the reasons why, but they are real, the statistics prove it and we have an issue there as well.
On employment support allowance appeals, the hon. Gentleman made an interesting point about those who have mental health issues, because when they go to an ESA appeal the issue is clearly not a physical one, because physically they can walk about, move their hands, brush their hair—if they have any, unlike me—or put a hat on their head. They are asked whether they can do those things, but those are not the questions that a person with mental illness needs to answer. They need to answer the questions, “Are you moody?”, “Do you fall out with people?”, “Are you aggressive?”, “How do you cope with difficult situations?”, “Do you start a task that you cannot finish?” Those are the questions for a person who is depressed, and I agree with the hon. Gentleman, because the appeals panel—the chair and those who deal with such tribunals—need to understand those issues better, so that an appeal can be presented in a way that people understand.
It has been stated that everyone has mental health issues. No one is immune, and although stress is greater among the poor and the unemployed it applies throughout society. Good mental health is crucial to the overall well-being of an individual, of societies and of countries.
In Northern Ireland there are about 150 suicides each year: 41% are single males, and 22% are males between 25 and 34-years old. Some 50% of suicides in the UK involve psychiatric patients, and one reason is a loss of contact; in that context I want to talk about soldiers, about a loss of contact by the health service and about treatment non-compliance, whereby people do not take the medication that doctors give them.
Figures for the United Kingdom as a whole indicate that depression accounts for about 60% of the country’s main health problems, alcoholism about 10%, Alzheimer’s about 8% and severe stress about 6%. That leads me on to that second issue, which is to do with our soldiers.
The week before last I had the opportunity to go to Cyprus with the armed forces parliamentary scheme. Some MPs in the Chamber will be members of that great scheme, some will be aware of it and some will have been members in the past. We have an opportunity to meet soldiers and to hear about strategic issues so that we can present them to the House in an informed and knowledgeable way.
When we were in Cyprus two weeks ago, we noted its importance from an Army and a strategic point of view, but we had not realised that it is halfway to Camp Bastion in Afghanistan. There is a new scheme in Cyprus whereby soldiers returning home from Afghanistan come through a so-called decompression centre in Akrotiri; last year 30,000 did so. They call it decompression because it helps them to unwind after what they have experienced in Afghanistan over the previous few months. The sun is usually shining, which makes a big difference. They have a chance to shower, to have their kit completely dry-cleaned, and to have a good meal. They have access to mobile phones, and they are able to speak to their doctor, padre or commanding officer. They have a chance to get back into normal life—to step down and get themselves ready to go back home to their family.
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The work done for our soldiers in the Akrotiri centre, which cost £4.5 million to build, gets them ready for life back home.
Those soldiers have seen in Afghanistan the most horrific things that we cannot begin to visualise. They have seen friends and colleagues killed or injured, some with life-changing injuries. We know of those people because we have met some of them, and we are humbled when we do so. The bullets and the bombs are intermingled with the stress, the trauma, the bad memories and the nightmares—those are all part of the things they have to face long after they leave the Army. While the Army, the Royal Navy and the Royal Air Force look after their personnel, the forces associations do likewise. We recognised from our time in Akrotiri, as we have in our constituencies, that once soldiers are out of the Army they are often distanced from those associations too. The Royal British Legion might not always be at hand for them. They might have no friends or their marriage might have split up. They might turn to drink and drugs, but that will give only temporary relief and they are still on their own. I am mindful that defence is not the Minister’s portfolio, but I hope that when he replies he will consider the welfare of our soldiers who have returned from Afghanistan, who are not in the forces any more because they have left or retired, and are now apart from the ritual and discipline that they were once very much part of.
Every one of us will be aware of constituents who have lost control because of the memories and nightmares of what they have seen. Whenever the memories flood back and the flashbacks reappear, they relive what they have come through, and then they face their demons alone. We need to face up to this issue confronting those who have served, and are serving, in the Army, the Navy and the Air Force. The health service needs to address it UK-wide, in England, Wales, Scotland and Northern Ireland. The plight of our soldiers should be a priority for this Government, as I know that it will be. I commend the motion to the House and hope that Members will support it.
2.43 pm
The Minister of State, Department of Health (Paul Burstow): There is no health without mental health. In that simple statement I sum up the coalition Government’s approach to mental health.
In contributing to this important debate, I start by congratulating my hon. Friends the Members for Loughborough (Nicky Morgan) and for Broxbourne (Mr Walker), among others, on tirelessly pursuing the case for having this debate on the Floor of the House. It is one of the rare debates that we have on this subject, and it clearly airs the issues that are so important to so many of our fellow citizens.
The hon. Member for North Durham (Mr Jones) said that it was a privilege to have the job—the vocation—of being a Member of Parliament, and I could not agree with him more. Sometimes, that privilege involves the surprise that we can still experience in the Chamber when debates are genuinely authentic and when people speak from the heart. I thank him for his candour and honesty; we need more of that. The chair of the all-party parliamentary group on mental health, my hon. Friend the Member for Broxbourne, talked, with humour and much else besides, about his experience with obsessive
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compulsive disorder. Anyone living and struggling with such conditions, who has not perhaps reached the point of wanting to talk about it, will feel huge respect for both Members for bringing the attention of the House to these matters. They have made us all wake up to something that we ought to know, but that we too often forget. That is that mental health is not a “them and us” game; it is about us—all of us. It touches us all in one way or another.
I am probably not going to be able to do justice to every contribution in the debate, not least those that I have not yet heard, but I assure hon. Members that I will continue to listen throughout the remainder of the debate, and that if any issues arise that I have not covered in this speech, I will write to the Members concerned to address those points.
The hon. Member for Strangford (Jim Shannon) made some important points about the support for our veterans, and for our armed forces more generally. This Government have done a lot in that regard—not least the commissioning by the Prime Minister of my hon. Friend the Member for South West Wiltshire (Dr Murrison) to produce his report, “Fighting Fit: a mental health plan for servicemen and veterans”. The report deals with many of these issues, and the Government take them, and the action that they require, very seriously.
Mr Kevan Jones: I congratulate the hon. Member for South West Wiltshire (Dr Murrison) on the report, but would the Minister acknowledge that it built on a lot of the work done by the previous Government, which I was responsible for?
Paul Burstow: I hope that there will be cross-party consensus on these issues today, and I shall take the hon. Gentleman’s question in that spirit. He makes a fair point. This is about building on what is working, and ensuring that it can work even better. The work done by my hon. Friend the Member for South West Wiltshire has certainly accelerated the pace.
When the Deputy Prime Minister and I launched the mental health strategy last year, we recognised the need to tackle the root causes of mental illness as well as ensuring that community and acute services provide timely treatment and care. We placed a strong emphasis on recovery from a human, rather than just a medical, perspective. We also made it clear that delivering significant improvements in people’s health and well-being requires parity of esteem between physical and mental health.
I know that some hon. Members are concerned that not enough emphasis has been placed on acute and in-patient care. Let me be clear. Our plans to provide a safe, modern, effective mental health service give equal emphasis to the full range of services, from public mental health and prevention through to forensic mental health services. This is about people receiving high quality, appropriate care when they need it. If services can intervene early—the case for that has already been powerfully made—so that mental health problems can be managed in the community before more serious problems develop, that should result in acute in-patient care being made available more quickly for those who need it.
My hon. Friend the Member for Loughborough mentioned the concerns raised by the Association of Chief Police Officers about places of safety. In partnership with the Home Office and the police, we are examining
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how to ensure that health services are properly commissioned in custodial situations. I would be only too happy to meet her and the ACPO mental health lead to discuss those issues further.
Jeremy Corbyn: Will the Minister look carefully into the circumstances of people who die either in police custody or in a mental health institution as a result of a mental health issue, to determine whether adequate forms of inquest and inquiry exist, and whether adequate lessons are being learned from the experiences? In view of what is going on in one or two inquests at the moment, I feel that there are some quite serious deficiencies in that area.
Paul Burstow: I thank the hon. Gentleman for his question. May I undertake to write to him about that matter in more detail? It has come up in our work on our suicide prevention strategy in relation to the nature of suicide verdicts, and narrative verdicts in particular, in coroners’ courts. I would be happy to come back to him on that issue.
In the past year, we have made progress across a broad front. We have committed £400 million to make psychological therapies available for adults of all ages, as well as for people with long-term health conditions and with severe and enduring mental illness. When it comes to our focus on recovery, the latest figures show that 44.4% of those who complete programmes recover and that more achieve lasting improvement. That puts us on track to achieve our target rate of recovery of over 50%.
Given that we know that the first signs of more than half of all lifelong mental illnesses can be detected in adolescence, we have to go further. That is why the Government are breaking new ground by investing in a new training-led approach to re-equip children and young people’s mental health services to offer a range of psychological therapies. I pay tribute to the leadership shown by YoungMinds. Without its support, we would not have come as far in this area as fast as we have.
I want to say something about the necessity of achieving the best possible outcomes for people in mental health crisis. Secondary mental health services across the country have made significant changes, both in community and hospital settings, including the provision of alternatives to psychiatric hospital admission. For example, more than 10,000 people with an early diagnosis of psychosis were engaged with early intervention services last year. That is the highest figure ever recorded. The improvements in community-based early intervention services are driving up standards of care, as well as reducing the demand for hospital admissions. I freely acknowledge that there is more to do and I take on board the point that my hon. Friend the Member for Broxbourne made about the need to look at the variability in the accessibility of mental health advocacy.
The development of recovery-focused services is a critical part of the Government’s strategy. That work is being led by the NHS Confederation’s mental health network and the Centre for Mental Health. They are supporting pilot sites that cover almost half of England and are making the kind of changes that service users have sought for years. The programme has identified 10 key changes to the way in which staff work, the types of services that are provided and the culture of organisations to embed recovery principles into routine practice.
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When I visited the South West London recovery college, I heard powerful personal testimonies from people who were living purposeful and fulfilling lives, and who were living with their illness rather than having to be cured of symptoms or illnesses. It is important that recovery is not just seen in medical terms, but is self-defined. Students at the college learn not only how to manage their condition, but skills to help them back to work and to form new relationships. Some become lecturers at the college themselves. I was told that being called a student, rather than a patient, helped people take control of their recovery, gave them more confidence and, crucially, made them feel normal, as opposed to being treated as a helpless, passive recipient of care.
Part of a good recovery is the ability to exercise more control over one’s life. In health care, that means that there must be more shared decision making and choice. In opening the debate, my hon. Friend the Member for Loughborough mentioned the principle of “no decision about me without me”. Undoubtedly, the any qualified provider policy and tariff reform have a part to play in that.
Adam Afriyie (Windsor) (Con): Many of us recognise that many people who come to our constituency surgeries, perhaps with a housing benefit inquiry or other benefit inquiry, are actually struggling with mental health challenges. It seems to me that the lack of control that results from the way in which Government services are designed can be a great contributing factor to stress and, therefore, to depression. The Minister is speaking about control. Can the design of public services, such as housing benefit and other benefits, be taken into account as a way of relieving the stress on a great number of our constituents?
Paul Burstow: That intervention rather helpfully moves me on to the point that has been made by several hon. Members about Atos. Although it is not my ministerial responsibility, a number of important points have been made about how it operates in particular cases. I will ensure that those points are taken into account by my ministerial colleagues at the Department for Work and Pensions. I will gladly pass them on.
Stephen Timms (East Ham) (Lab): The Minister will know that mental health charities have proposed changes to the mental health descriptors in the work capability assessment for employment and support allowance. There seems to be some delay in implementing those. Will he pick that up in his discussions with his colleagues?
Paul Burstow: I will certainly act as the messenger and pass that point on, as the right hon. Gentleman has requested.
Stigma has been referred to in this debate. It is undoubtedly one of the biggest barriers to access to mental health services in this country. The Government are determined to reduce the prejudice and discrimination that surround mental health, but we recognise that we cannot do that on our own. That is why Mind and Rethink Mental Illness have developed a major anti-stigma programme called “Time to Change”. That campaign is working and is delivering significant behavioural change across society. That is why the Government are contributing the substantial amount of £16 million up to April 2015.