§ 2. Mr. Tony Lloyd (Manchester, Central)If will make a statement on the provision of in-patient beds for mental health patients in urban areas. [67265]
§ The Minister of State, Department of Health (Jacqui Smith)Each mental health service user who is assessed as requiring a period of care away from their home should have timely access to an appropriate hospital bed or an alternative bed or place. In the NHS plan, we set down our commitment to create 500 extra secure beds and 320 extra 24-hour staffed beds. We have met this target.
§ Mr. LloydI hope my hon. Friend will tell the House that mental health, always the Cinderella of the health service, will have a fair share of the huge increase in spending on the health service, because that is vital. On a specific problem, the number of patients in Manchester—the figure is typical of urban areas—who have been sectioned under the Mental Health Acts now accounts for 50 per cent. of the beds occupied compared with only 20 per cent. 10 years ago. The problem is that patients have to queue up for in-patient beds. Unless we provide more beds to get the balance right, people will be given a bed only when they have reached crisis point. Beds need to be available earlier, when it is cheaper and better for the patients.
§ Jacqui SmithMy hon. Friend makes an important point about the priority previously afforded to mental health services. With the publication of the mental health national service framework and the NHS plan, the Government have made mental health one of the top three clinical priorities.
My hon. Friend also outlines the problem that occurred because of the low priority given to mental health and, of course, the low investment in it, which meant that there was a reduction over many years in the number of acute beds available. The Government are determined to turn around the investment and to give mental health the priority it deserves. The Manchester mental health and social care 140 trust has received additional investment of £1.4 million from its commissioners this year, specifically to open 10 additional NHS beds and to strengthen community mental health provision with the implementation of a crisis resolution service in the city, which experience elsewhere suggests can lift pressure on acute beds. I agree that for too long there has been a lack of investment in, and commitment to, our mental health services. We are determined to put that right.
§ Mr. Robert Key (Salisbury)A month ago on 18 June I raised with the Secretary of State the crisis in the Avon and Wiltshire mental health partnership NHS trust. He said that it was all a matter of money. I wrote to the Minister on 29 April and she told me in a written answer that she would reply as soon as possible. Councillor Christine Reid, the Labour councillor who chairs that trust, has not replied to my correspondence. The matter is urgent. It is not party politics; it is process. In particular, it reflects a breakdown in the mental health system in south Wiltshire. If the Minister cannot answer, will she at least see me to explain why the trust has lost £60,000 for the alcohol and drug advisory service and how the Government expect the new trust to function with an initial deficit of £500,000?
§ Jacqui SmithI apologise if I have failed to respond to the hon. Gentleman's letter. I will ensure that he gets an answer. I have discussed issues to do with that trust with its chair and I am willing to discuss progress in his constituency with him. However, part of that discussion may well concern the difference in our approaches to investment in mental health services. The Government have made it clear that we are investing more in those services and will continue to do so; but the hon. Gentleman, and in particular his Front-Bench colleagues, have opposed that investment. That would have to be part of any conversation that we had about how to improve our mental health services.
§ Mrs. Joan Humble (Blackpool, North and Fleetwood)Will my hon. Friend pay particular attention to in-service provision for children who present with serious psychiatric problems? All too often, they are inappropriately placed either on general paediatric wards or in adult mental health provision; they need their own specialist services, and I hope that my hon. Friend will consider the provision of such in-service beds.
§ Jacqui SmithMy hon. Friend raises an important point. Mental health services for children and adolescents were perhaps treated even more poorly than adult services by the previous Government when it came to showing interest and making investment. The £105 million of investment in child and adolescent mental health services has begun to bring those services out of the shadows and enabled us to develop the specialist provision, including in-patient beds, for which my hon. Friend argues.
My hon. Friend made an important point also about the inappropriate placement of young people in adult services. Sometimes that happens because local services have failed to plan the transition of responsibility from child and adolescent services to adult services. In the children's national service framework we will consider carefully how to take forward the work towards higher standards in child and adolescent mental health services.
§ Sandra Gidley (Romsey)According to recent guidance from the National Institute for Clinical Excellence, the majority of studies show that the higher cost of purchasing atypical antipsychotics is more than offset by the reduction in in-patient stays. This morning, at a conference attended mainly by psychiatrists, more than two thirds of those present said that funding was a barrier to prescribing atypicals. How will the Minister ensure that adequate funding is provided to increase their prescription?
§ Jacqui SmithThe hon. Lady rightly points out, as do the NICE guidelines, the potential benefits for the service as a whole and for individuals of being able to prescribe atypical antipsychotics in the appropriate circumstances. It was to secure those benefits that we set up NICE to develop such guidelines and to involve users, which is another important way in which we develop our services. We are investing in our mental health services, and we have earmarked extra investment for service delivery and the development of new services.
§ Sandra Gidleyindicated dissent.
§ Jacqui SmithFor Liberal Democrats the investment is never enough. The difference between sitting on the Opposition Benches and sitting on these Benches is that we make the decisions, we provide the investment and we set the priorities. We said that mental health was a priority; that is making a difference at a local level and I am confident that it will continue to do so.
§ Glenda Jackson (Hampstead and Highgate)Despite the excellent work that has already been done by the rough sleepers initiative, the condition of many mentally ill people in London is exacerbated by the fact that they are of no fixed abode. Given the peripatetic nature of their lives, it is not unusual for homeless people who are mentally ill to reach and pass the point of crisis and to find it impossible to gain any medical treatment. It is bad enough to be without a home, but surely to be denied access to the NHS is unacceptable. Will my hon. Friend please consult the Mayor's health commission to examine the additional needs for such services on a much broader than borough-by-borough basis?
§ Jacqui SmithMy hon. Friend makes an important point about the needs of the homeless. As we develop our mental health policies—in particular, the new community teams which, in parts of London, have been able to reach out to people in the community, even people without homes who have previously been unable to access services or have not be able to access those services early enough—I am happy to talk to anyone to make sure that they deliver improvements for the most vulnerable people cited by my hon. Friend.