HL Deb 11 July 2001 vol 626 cc1083-6

3.2 p.m.

Lord Clement-Jones

asked Her Majesty's Government:

What priority is being given to implementing policies designed to improve public services for people with a mental illness.

Lord Hunt of Kings Heath

My Lords, mental health is a key priority for this Government and we have set out our policies in the national service framework and the NHS Plan. This week we have also announced a new national institute for mental health to drive forward progress in England.

Lord Clement-Jones

My Lords, I welcome the Minister's reply. There is, however, mounting evidence that the new money intended by the Government to improve mental health services is being spent on other NHS priorities. Will the noble Lord give an assurance that he will review the situation and ensure that the new cash reaches the intended mental health services?

Lord Hunt of Kings Heath

My Lords, resources are very important. As part of the NHS Plan we made it clear that, in addition to normal revenue spending, £329 million would be devoted to mental health over the next three years. We expect NHS authorities and trusts to ensure that they devote as much priority as they can to mental health. I believe that the fact that the national service framework is such an integral part of the NHS Plan is confirmation that we take the matter very seriously.

Lord Walton of Detchant

My Lords, in asking a supplementary question I must declare an interest as occasionally I give neuroscience advice to a pharmaceutical company which produces drugs used in the treatment of mental illness. I should like to ask the Minister about the use of so-called atypical antipsychotic drugs in the treatment of schizophrenia. There is now clear evidence in the recent report of the Zito Trust that in the United Kingdom the number of patients who are being given these drugs for the treatment of their illness is far lower than in many other countries. That is particularly unfortunate given that these drugs are more effective and much freer from side-effects than traditional remedies. That report of the trust demonstrates a very clear postcode prescribing problem of enormous variability across the United Kingdom. What action do the Government propose to take to try to correct that unfortunate situation?

Lord Hunt of Kings Heath

My Lords, the advice I have received is that there is no strong evidence that atypical drugs are superior to the older-style antipsychotic drugs, although the incidence of side-effects, as the noble Lord, Lord Walton, suggests, has been reported to be lower. However, that observation may well result, at least in part, from the fact that excess dosage of traditional drugs has tended to be used in studies which compare old and new medications. I am aware of the work that the Zito Trust has undertaken. The technology appraisal of these drugs is in the work programme of the National Institute for Clinical Excellence. That is due in late November of this year, unless there are any appeals, and in turn it will feed into NICE guidelines on the management of schizophrenia which are due in 2002. The whole purpose of the work of NICE is to ensure much greater consistency of approach and bring an end to postcode prescribing.

Baroness Knight of Collingtree

My Lords, is the Minister aware of the widespread and growing public concern about the treatment offered to sufferers of schizophrenia? Is the noble Lord aware that the level of care is severely cut from what it was a few years ago, and will he please try to recognise the concern that is expressed?

Lord Hunt of Kings Heath

My Lords, I recognise the concern going back many years about whether mental health service policies are effective and enough resources are being devoted to them by the health service. I believe that we have made considerable progress in the past few years. For example, we have increased the number of additional secure beds and established assertive outreach teams. The national service framework and the information and targets contained in the NHS Plan all show that we are determined to improve the quality of the service on offer. One factor in all this is our ability to attract more staff to work in this area. Clearly, we are keen to ensure that we increase the number of consultant psychiatrists and psychiatric nurses who can help us to provide the kind of service to which the noble Baroness refers.

Lord Tebbit

My Lords, does the Minister agree that, if one considers mental illness and the pain that it causes to the sufferers themselves and the destruction of their families and friends in so many ways, the amount of money spent on looking after those patients is disproportionately small? Furthermore, does the Minister agree that the amount of money which goes into research to try to understand the causes of, and effect cures for, such illness is disproportionately even smaller? Can the noble Lord do something more, particularly about the latter?

Lord Hunt of Kings Heath

My Lords, I agree with the noble Lord that there is a huge number of people in this country who in one way or another are affected by mental health problems. At the moment, 630,000 people are under the care of specialist mental health services. It is also believed that one in six people will have a mental health problem at some time in their lives. As far as concerns expenditure, the latest figures for 1998–99 indicate that for the NHS the total for mental health was just over £3 billion, and another £564 million was spent by local authorities. The NHS figure of just over £3 billion compares with the total spend for the NHS as a whole of £36.9 billion. Therefore, the proportion is just under 10 per cent. I agree that we need to ensure that we are spending sufficient resources. I believe that the impact of our policies will increase resources over time. We have a large research and development programme. One of the changes that we are making at the moment is to tie the research spend much more into our overall priorities, one of which is mental health. I very much take the point that we need to ensure that we invest enough in research in this area.

Lord Hylton

My Lords, is the Minister able to report any progress on providing secure wards in general and other hospitals so that mentally ill prisoners can be transferred there and receive the treatment and care that they need?

Lord Hunt of Kings Heath

My Lords, the noble Lord has raised a very important matter. We announced when we came to office that we would increase the number of additional secure beds. We have been able to do that by 500. So far as concerns the relationship between the Prison Service and the NHS, I agree that we must do everything that we can to ensure that there is appropriate co-ordination to enable the proper transfer of prisoners. There is a task force from the Home Office and the Department of Health which is concerned to improve the healthcare of prisoners and to ensure that the NHS makes a major contribution to that. That is making considerable progress.

Baroness Trumpington

My Lords, is the Minister satisfied with the way in which information about a person suffering from mental illness is transferred when he is moved from one authority to another? When I had the Minister's job my experience was that serious matters emerged, simply because the new social security office had no idea about the past of the person concerned.

Lord Hunt of Kings Heath

My Lords, I do not know about the social security office, but certainly so far as concerns the National Health Service there is much that we can do to improve communications and the transfer of records. I have been given responsibility for IT in the health department. I not know what I did to deserve that. There are many improvements that we can make. The information strategy that we have developed provides the framework in which to improve the transfer of patient information.

Lord Pearson of Rannoch

My Lords, can the Minister tell the House whether the Government have conducted any research into the possible use of village-type communities for, particularly, the more severely mentally ill? The Government will be aware of the enormous cost-effectiveness and care-effectiveness of these communities for the mentally handicapped.

Lord Hunt of Kings Heath

My Lords, I shall certainly see whether any research has been undertaken and let the noble Lord have a copy of it. We need a range of treatments and rehabilitation available to people suffering from mental health problems. I well understand the point the noble Lord raises. There is much that we can do to improve community provision. We certainly need to redouble our efforts in that area.