§ 1. Mr. Edward Davey (Kingston and Surbiton)What plans he has to implement the proposals in the Wanless report to create a world-class mental health service; and if he will make a statement. [59118]
§ The Secretary of State for Health (Mr. Alan Milburn)The NHS plan and the national service framework for mental health will, when implemented, go a long way to creating a world-class mental health service, as proposed in the Wanless report. Targets set out in the NHS plan are on schedule to be reached by 2004. Details of our additional investment will be given in due course.
§ Mr. DaveyI thank the Secretary of State for that answer. In implementing the Wanless proposals for a world-class mental health service, will the right hon. Gentleman ensure that users and carers have a much greater role in setting local priorities and strategies? Has he shared my experience that in many aspects of mental health, including minor and moderate illnesses, users and carers can help to build cost-effective community self-help solutions, if they have resources and support? Will he ensure that the forthcoming mental health Bill places a new statutory duty on NHS trusts dealing with mental health services to involve users and carers far more extensively in the planning of local services?
§ Mr. MilburnThe general proposition that the hon. Gentleman advances is perfectly reasonable. If we want a service—including a mental health service—that is properly built around the needs of the people who use it, they should have a greater say in how the service is provided. That goes for their carers, too. People caring for those with a mental health problem do a sterling job: without them, the NHS could not do its work.
The hon. Gentleman will have to wait to see the provisions of the forthcoming mental health Bill, but I accept the proposition, which applies equally to mental health services and to the national health service in general.
§ Liz Blackman (Erewash)Wanless anticipated an increase in the prescribing of anti-psychotic atypicals for 136 mental health patients with schizophrenia. May I take this opportunity to congratulate the National Institute for Clinical Excellence on its timely approval of the guidance? Not only will that decision make those drugs more available to patients with schizophrenia and lower the cost of in-patient care but, more important, it will drastically reduce the terrible long-term and irreversible side effects suffered by so many schizophrenia patients currently taking typicals.
§ Mr. MilburnNICE' s decision has been broadly welcomed, not only within the service but by users and carers. The atypical anti-psychotics are certainly a real step forward, not only for their safety and lack of side effects but for the good that they do. NICE is often in the news for—as it were—the wrong reasons. There is much criticism of NICE, which has a difficult job, but people should stand back and consider what it has done: it has made available more—or more cost-effective—services in the national health service. It has driven up the drugs bill in the health service, but I do not think that is a bad thing if it means that we are getting more cost-effective and more clinically effective treatments to more patients—and, in this case, that is certainly so.
§ Mr. Robert Key (Salisbury)But we are getting less effective treatment to fewer patients. On 29 April, I wrote to the Minister of State, the hon. Member for Redditch (Jacqui Smith), to point out that the brand new mental health service in Avon and Wiltshire has inherited a £500,000 deficit; that clinical judgment is that GPs cannot provide the necessary service; that the rehabilitation service is under threat; and that there is a six-month wait for an appointment with the alcohol and drug advisory service. The good lady who is the chairman of that trust—a very nice Labour councilor—came to see me in Salisbury to apologise, but why should she take the flak when the resources are not in the service?
§ Mr. MilburnI am absolutely delighted to hear that there are such creatures as nice Labour councillors—I bet the hon. Gentleman was even more surprised.
On the overall position with mental health services, of course there are real problems and my hon. Friend the Minister and I are the first to acknowledge them. However, the national health service and mental health services are moving forward; there is more capacity than there was.
The issue for the hon. Gentleman is extremely straightforward, however: if he wants his local health service to expand, he needs to commit more resources to the national health service and agree to do what we have done—to put more money into the national health service over a longer period than has ever been done before. I bet my bottom dollar that the hon. Gentleman was one of those who voted against the extra money for the national health service.
§ Roger Casale (Wimbledon)As someone whose mother worked in the psychiatric unit at Kingston hospital, I can tell my right hon. Friend that mental health services have increased by leaps and bounds under the present Government. South West London and St. George's mental health NHS trust is a pioneer in the field of care for mentally ill people. It is a centre of excellence 137 and an example of the best practice that, with the support, money, investment and reforms that the Government are putting in, can be spread around the country.
§ Mr. MilburnI am grateful for my hon. Friend's comments. As I go around the country visiting mental health or other services, I am the first to acknowledge that there are considerable problems. Indeed, it is better to be straight about such things and to say that it will take some time for the problems to be put right. However, what is completely wrong is to say—as the Opposition do—that there is no progress in the national health service. We should be clear about why they say that: they want to run down the national health service. They want to see it fail, whereas we want it to succeed.
§ Mr. Oliver Heald (North-East Hertfordshire)Is not the task for the Secretary of State to match the rhetoric with action? How can the Government hope to create a world-class mental health service when the experience on the ground is one of service reductions, as my hon. Friend the Member for Salisbury (Mr. Key) says? Will the right hon. Gentleman comment on the fact that the Buckinghamshire Association for Mental Health wrote to me saying that
not only is there now no new money but there is less funding available and therefore service cuts"?I received a letter from Manchester about cuts of £820,000 in mental health services. Cuts are planned in Shropshire. In north Cumbria—my Chief Whip gave this letter to me—there is talk of the patients counselling service being under threat. The British Association for Counselling and Psychotherapy said that that wasbad for patients, bad for doctors".So why are there service reductions all over the country, despite Ministers talking about money going in and improvements being made? Is not that just another case of Labour not telling the truth about what is happening in this country?
§ Mr. MilburnNo, it is not; it is a case of the Conservatives running down the national health service. I point out to the hon. Gentleman that almost 500 extra secure beds have been created in the health service and that there are more than 320 extra 24-hour staffed beds and 180 extra assertive outreach teams because of the extra investment in the NHS. Finally, more than 50 crisis resolution teams are available in communities throughout the country, dealing with some of the most vulnerable people in the community, precisely because of the extra investment in the NHS. There is a simple choice for the country: either we continue to invest—as we promise to do not for one year, but for five or six years at record levels—or we do what the Conservatives now propose and cut investment in the NHS.