Mental Health Services (Hansard, 17 June 2003)

§ The Parliamentary Under-Secretary of State, Department of Health (Lord Warner)
My Lords, good progress is being made. The most recent data show that 212 out of 220 assertive outreach teams targeted in the NHS Plan are already in place. Progress is slower for some targets, such as early intervention and crisis resolution teams. But delivery plans prepared by strategic health authorities show that over 80 per cent of team targets and over 60 per cent of new worker targets are on course to be met. That confirms the report by the Commission for Health Improvement, published in February this year which concluded that, although mental health services started from a very low point, progress is being made and that this is bringing tangible rewards of better care and support for service-users and carers.

§ Lord Ashley of Stoke
My Lords, I offer my noble friend a very warm welcome and wish him every success in his new post.

Noble Lords
Hear, hear!

§ Lord Ashley of Stoke
My Lords, is my noble friend aware that 58 per cent of those involved in a recent 657 survey by MIND of people with mental health problems claimed that they were not receiving adequate treatment from the National Health Service? As that is such an enormous figure involving very vulnerable people, does it not pose a major challenge for the health service, especially as it is supposed to provide a comprehensive service? Will the Government look into those claims, and do what they can to help?

§ Lord Warner
My Lords, I thank my noble friend for his kind remarks. It is true that the MIND report revealed areas of great concern. We all acknowledge that, with mental health services, we are starting from a pretty low base. But one of the particularly good things happening is the project to strengthen the workforce with up to 1,500 new graduate primary care workers and gateway workers working in primary care teams coming on-stream by the end of 2004. It is a people industry. We are doing a lot of work to encourage more people into this area of work.

§ Lord Clement-Jones
My Lords, I also congratulate the Minister on his return to the government Benches in such style. I am sure that he has not considered all the nuances of the MIND report on mental health—the hidden costs report to which the noble Lord. Lord Ashley of Stoke referred. However, is not the current National Health Service prescription policy one of the core problems? Sufferers of chronic diseases such as epilepsy and diabetes do not have to pay for prescriptions. The noble Lord, Lord Lipsey, when launching the report on Monday, described the NHS prescription policy as a "dog's dinner". Does the Minister agree with that?

§ Lord Warner
My Lords, I am not sure what dogs eat, but I shall be happy to look into prescription charges. I do not promise any changes, because I am still finding my way around this subject. I shall study the MIND report, and shall be happy to write to the noble Lord, Lord Clement-Jones.

§ Baroness Knight of Collingtree
My Lords, notwithstanding the uncertainty of the noble Lord, Lord Warner, about dogs' diets, there is a warm welcome for him from this side of the House in the difficult job that he now faces. Bearing in mind that the problem for mental patients starts when they leave hospital, will the noble Lord assure us that care has been considered, and given, to patients who have left mental care but need constant surveillance, especially with regard to diet and drug intake?

§ Lord Warner
My Lords, I thank the noble Baroness, Lady Knight, for her kind remarks. I share her concerns about people with psychiatric conditions leaving longer-stay and medium-stay hospitals. The Government are putting much emphasis on strengthening primary care teams. We are bringing in new people to work in the area, so that the support in the community can be strengthened. That is why we 658 should be positive about the assertive outreach teams. They sound jargonish, but the people involved work at a local level finding hard-to-help people with mental illness and providing them with support and services.

§ Baroness Masham of Ilton
My Lords, is the Minister satisfied with the treatment of mentally ill people in prison and the links with the community when they are discharged?

§ Lord Warner
My Lords, I know from my previous incarnations that big changes are in prospect as the NHS takes greater responsibility for prison health services. We are seeing a changeover, with more prisons in England and Wales for which the NHS is providing the health service. We expect there to be considerable improvements over time. However, there is a backlog of service development in the prison health services just as there is in mental health outside the Prison Service. Progress is being made, and more than 40 prisons now receive health services from the NHS under local agreements.

§ Baroness Uddin
My Lords, I warmly welcome my noble friend Lord Warner to the Front Bench. I am sure that he recognises that the level of services for black and minority people with mental illness remains highly inappropriate because he had an enormous amount of contact with black men in his previous incarnation. What does my noble friend intend to do about that problem? How will he ensure that the level of service provided is in tandem with our commitment to equality of opportunity legislation?

§ Lord Warner
My Lords, I thank my noble friend Lady Uddin for her remarks. The Government published a document in March called Inside Outside: Improving Mental Health Services for Black and Minority Ethnic Communities in England. That report signals an important step forward to support the reform of mental health services for people from black and minority ethnic communities in this country. Again, there is a large heritage of change and problems to be tackled. We are trying to engage with these areas of difficulty, and we recognise that the black and minority ethnic communities have much ground to make up in terms of their access to mental health services.

§ Baroness Noakes
My Lords, I, too, welcome the noble Lord, Lord Warner, to the Front Bench with responsibility for health matters. I am sure that he, like me, is eagerly awaiting the Health and Social Care Bill from another place. I promise him interesting times this summer and autumn. Is the Minister aware of the Royal College of Psychiatrists' estimate that one in three consultants intend to retire early? What will the Government do to deal with that imminent crisis in the NHS?

§ Lord Warner
My Lords, I thank the noble Baroness, Lady Noakes, for her remarks. I am not sure whether her promise was a promise—or, indeed, a 659 threat—but I shall take it in the spirit in which it was offered. I am aware of the shortage of psychiatrists and of the prospect of further retirements that she mentioned. I am not fully up to steam on everything going on in this particular area, so I can only speak with all the authority on this subject that 24 hours in the job justifies. However, I shall look into the matter and will be in touch with the noble Baroness, Lady Noakes.

§ Baroness Howarth of Breckland
My Lords, we also welcome the noble Lord, Lord Warner. We are sorry to lose him so quickly from these Benches. Having heard about all that will happen in the statutory sector, how does the noble Lord see the role of the voluntary organisations working in this area of supporting mentally ill people? Much of the work is carried out by organisations such as Saneline, MIND and YoungMinds, many of which are struggling. What support will the Government give in addition to that given to the statutory sector?

§ Lord Warner
My Lords, I thank the noble Baroness for her remarks. She will know that my noble friend Lord Filkin, in his previous incarnation, worked with the voluntary sector through initiatives like the futurebuilders fund to improve capacity in the voluntary sector.
The Government take this area seriously. We want to see the voluntary sector make a full contribution to the development of these kinds of services, which are valued by the public. They often have a unique capacity to make provision with a particular added value. Mental health is an area that will be open to the voluntary sector to use the kind of capacity-building strengths that the Government are introducing to help to develop services.

§ Lord Pilkington of Oxenford
My Lords, in view of mental health, and other, problems with prisoners—67 per cent of whom are illiterate—is the Minister happy that only one in 20 of them can get to education programmes at Brixton? Is that the policy of Her Majesty's Government? Can the Government help people in this way?

§ Lord Warner
My Lords, the noble Lord's queries do not have much to do with the Question. I leave him to pursue his inquiries with the Minister responsible.