0:00:14 > 0:00:19Order. Urgent question, Barbara Keeley.To ask the Secretary of
0:00:19 > 0:00:22State for Health and social care to make a statement on the Care Quality
0:00:22 > 0:00:26Commission's review of children and young people's mental-health
0:00:26 > 0:00:33services.Minister at Steve Brine. Thank you very much, Mr Speaker. I
0:00:33 > 0:00:38can tell you Mr Speaker, tomorrow they can quality commission
0:00:38 > 0:00:41published their report, if review of children and young people's mental
0:00:41 > 0:00:47health services. It is entitled, are we listening? Yes, we are, Mr
0:00:47 > 0:00:50Speaker. This is the second piece of work to look at this area of
0:00:50 > 0:00:55services. Finding examples of good and innovative practice and
0:00:55 > 0:00:59dedicated people. We thank everyone of them working in every part of the
0:00:59 > 0:01:04system. A number areas of strong practice making sure that patients
0:01:04 > 0:01:10and their families are involved in planning care and concerns about the
0:01:10 > 0:01:15join up. Let me thank the CQC and the doctor and his team for their
0:01:15 > 0:01:20work. The Government has already committed to making an additional
0:01:20 > 0:01:23£1.4 billion improvement or health services and deliver on the
0:01:23 > 0:01:28commitments in future in mind and the review of mental health. CQC
0:01:28 > 0:01:31welcomes this progress in their report, I know it. Spend is reaching
0:01:31 > 0:01:37the front line. It is an issue I note the back honourable lady and
0:01:37 > 0:01:41members have concerns about. By 2021, we have committed to ensuring
0:01:41 > 0:01:4570,000 more young people have access to high-quality mental health care
0:01:45 > 0:01:49when the need it. We know there are so much more to do, Mr Speaker. As
0:01:49 > 0:01:54clambered up, the National health director for NHS England said in
0:01:54 > 0:01:59response to this report, Cannes services are now improving, but
0:01:59 > 0:02:04historic underfunding, legacy understaffing and rapidly growing
0:02:04 > 0:02:11need as we are seeing across the service. December, jointly with the
0:02:11 > 0:02:14Department for Education, we published this green paper, which
0:02:14 > 0:02:18responds to a number of problems raised by the CQC in this report and
0:02:18 > 0:02:21sets out a range of proposals to strengthen the way schools and
0:02:21 > 0:02:25specialist NHS mental health services work together and to reduce
0:02:25 > 0:02:29the amount of time that children and young people have to wait to access
0:02:29 > 0:02:33specialist help. These proposals are backed by an additional £300 million
0:02:33 > 0:02:36of funding. We have carried out an extensive face-to-face consultation
0:02:36 > 0:02:41and received a very high level of responses to our online consultation
0:02:41 > 0:02:46and we thank everyone from that. We will respond to that this summer.
0:02:46 > 0:02:50The report also calls for the Secretary of State to use the
0:02:50 > 0:02:53interministerial group on mental health to guarantee greater
0:02:53 > 0:02:56collaboration across Government departments and prioritising mental
0:02:56 > 0:02:59health. We agree, this recommendation is already in hand,
0:02:59 > 0:03:02Mr Speaker. The IMG has already contributed to the development of
0:03:02 > 0:03:06the Queen paper and will continue to provide leadership on the issues
0:03:06 > 0:03:11that this report raises. The CQC also recommend that everyone works,
0:03:11 > 0:03:14volunteers and cares for young people is trained in mental health
0:03:14 > 0:03:18awareness. We rolling out training to every secondary school and have
0:03:18 > 0:03:21committed to rolling out mental health awareness training to all
0:03:21 > 0:03:26primary schools by 2022. This Government, Mr Speaker, and these
0:03:26 > 0:03:30ministers remain committed wholly to making mental health everybody's
0:03:30 > 0:03:32business and building good mental health for our children and young
0:03:32 > 0:03:40people stop all.Barbara Keeley. This is the recent piece of evidence
0:03:40 > 0:03:45revealing systematic failings in our mental health services. Similar
0:03:45 > 0:03:49reports in the last few weeks call into question the Government's
0:03:49 > 0:03:52claims to have made mental health and equal priority to physical
0:03:52 > 0:03:57health. We see evidence of services actively putting up barriers to
0:03:57 > 0:04:00treatment, resulting in children and young people having to reach crisis
0:04:00 > 0:04:03point before being able to get access to the right treatment.
0:04:03 > 0:04:07Children are suffering because of these high eligibility thresholds.
0:04:07 > 0:04:10Mr Speaker, we know that 50% of mental health problems develop
0:04:10 > 0:04:16before the age of 14, and 75% develop before the age of 18. Does
0:04:16 > 0:04:20the Minister recognise that imposing high eligibility thresholds means
0:04:20 > 0:04:24children and young people are treated only when their condition
0:04:24 > 0:04:29becomes more serious? And these high thresholds or even pointing is about
0:04:29 > 0:04:31prompting GPs to tell children to pretend that their mental health is
0:04:31 > 0:04:36worse than it is. Will the Minister agree to look into referral criteria
0:04:36 > 0:04:39as a matter of urgency to ensure that young people are getting proper
0:04:39 > 0:04:44treatment at the right time? Now, the report linked excessively high
0:04:44 > 0:04:48eligibility thresholds and reductions in access with funding
0:04:48 > 0:04:51reductions and not enough capacity for services to respond to local
0:04:51 > 0:04:55needs. Whatever the Minister says, clearly not enough money is reaching
0:04:55 > 0:04:59the front line. Can the Minister tell us how he plans to address
0:04:59 > 0:05:04this? Now, this report, like the CQC's recent report into
0:05:04 > 0:05:07rehabilitation services, raises questions about out of area
0:05:07 > 0:05:11placements, and we know that these are barrier to recovery. Can the
0:05:11 > 0:05:14Minister tell the House what action is being taken to increase the
0:05:14 > 0:05:18number of inpatient beds locally. Finally, the transition from
0:05:18 > 0:05:22children's to adult mental health services at 18 is also a barrier to
0:05:22 > 0:05:26accessing care. What is the Minister going to do to address the clear
0:05:26 > 0:05:29plop some problem is highly dead in this report and others associated
0:05:29 > 0:05:34with the ridge and transition age 18 from child and adolescent services
0:05:34 > 0:05:39to adult mental health services. Minister.Thank you, Mr Speaker. She
0:05:39 > 0:05:45rightly raises spend reaching the front line. I said in my opening
0:05:45 > 0:05:50remarks it is doing so. She asked what evidence there is that. Well,
0:05:50 > 0:05:56last year we saw a 20% increase on Clinical Commissioning Group for
0:05:56 > 0:06:03young -- children and young people's mental health services. It rose to
0:06:03 > 0:06:11£690 million in 2016-17. The broad issues raised in the response...
0:06:11 > 0:06:14Mean, I mean, I said that we have made up to £1.4 billion available
0:06:14 > 0:06:18over a five-year period to support the transition of these services and
0:06:18 > 0:06:25an extra £300 million. I would want to mention waiting times and
0:06:25 > 0:06:29referral routes in that. On waiting times, we are the first Government
0:06:29 > 0:06:35two and reduce waiting times standards. And -- to introduce
0:06:35 > 0:06:41waiting times standards. Both either our meeting or are on track to meet
0:06:41 > 0:06:45their target, we will be piloting a four-week waiting time for
0:06:45 > 0:06:48specialist mental health services as outlined in the recent green paper.
0:06:48 > 0:06:54We are considering their report and the responses to that. Our green
0:06:54 > 0:06:58paper proposals for the senior designated mental health support
0:06:58 > 0:07:03teams, the new workforce, which are based on the findings of the DfE's
0:07:03 > 0:07:07schooling pilot, they aim to improve the join up with specialist services
0:07:07 > 0:07:12and result John Morra appropriate referrals. She is shaking her head,
0:07:12 > 0:07:17but I can only tell her the facts. -- result in more appropriate
0:07:17 > 0:07:21referrals. The workforce recognise new ways of working as a cornerstone
0:07:21 > 0:07:26of delivering these improvements. We will be working with our partners to
0:07:26 > 0:07:36continue the expansion
0:07:38 > 0:07:40of the newly created roles in mental health services and considering the
0:07:40 > 0:07:43creation of new roles, such as early intervention workers, focusing on
0:07:43 > 0:07:45child well-being as part of the psychiatrist led team. That was my
0:07:45 > 0:07:47cue, Mr Speaker, thank you.Order, many honourable members and right
0:07:47 > 0:07:50honourable members are seeking to catch my icon but can I remind you
0:07:50 > 0:07:52that there is the business questions followed by an important statement
0:07:52 > 0:07:56by the Home Secretary, thereafter, the debate on International Women's
0:07:56 > 0:08:01Day is heavily subscribed. There is a premium upon brevity and I do want
0:08:01 > 0:08:04to move on, whether we've reached everybody and incorporated everybody
0:08:04 > 0:08:09or not, no later than 11am. Single sentence questions are much to be
0:08:09 > 0:08:17provoked. Fiona Bruce.Can I commend promoting the emotionally healthy
0:08:17 > 0:08:20schools Project, which is engaging not just children who have
0:08:20 > 0:08:24challenges but also their families. Would the Minister agree that
0:08:24 > 0:08:28helping children with mental health charities need to involve wherever
0:08:28 > 0:08:32practical by families, family relationships, and they're into
0:08:32 > 0:08:34parental relationships as recommended by the early
0:08:34 > 0:08:39intervention foundation?As ever, my honourable friend makes the point
0:08:39 > 0:08:43about families. I mean, I said we are already rolling out the mental
0:08:43 > 0:08:46health training for every secondary school, and of course that is
0:08:46 > 0:08:50important and we are committed to rolling out mental health awareness
0:08:50 > 0:08:55training to primary schools by 2022. Yes, to coin a phrase, it takes a
0:08:55 > 0:08:58Village. It is about the state, and the schools are part of that. It is
0:08:58 > 0:09:02also about the third sector, who have an important role to play. And
0:09:02 > 0:09:06it absolutely is about the love and support and the Christian embrace of
0:09:06 > 0:09:13families.This is a very important issue, especially given that half of
0:09:13 > 0:09:16mental health problems are established by the age of 14, it is
0:09:16 > 0:09:21shocking that some children are only receiving assistance after
0:09:21 > 0:09:25attempting suicide. I note that Claire Murdoch, the National mental
0:09:25 > 0:09:30health director for NHS in wind has dated, child and adolescent mental
0:09:30 > 0:09:37health services are suffering of a legacy of underfunding and
0:09:37 > 0:09:40understaffing. This report is surely an example of the latest reports in
0:09:40 > 0:09:44recent years demonstrating the impact of this Government austerity
0:09:44 > 0:09:48distributed agenda to public services. By comparison in Scotland,
0:09:48 > 0:09:51which have the UK's first ever dedicated mental Health Minister, we
0:09:51 > 0:09:56have seen staff at full Scotland's mental health care services at a
0:09:56 > 0:10:02record high, a 79% increase. Surely as part of this response to these
0:10:02 > 0:10:06findings, the Minister may wish to look at actions being taken in
0:10:06 > 0:10:10Scotland and learn from those.We always look at the actions that are
0:10:10 > 0:10:15being taken in Scotland and all the devolved administrations. He's quite
0:10:15 > 0:10:19right to have touched on prevention, the first point that he made. The
0:10:19 > 0:10:23green paper is focused on providing significant support for schools to
0:10:23 > 0:10:27develop the work they already do on prevention and early intervention. I
0:10:27 > 0:10:31just would say that in these exchanges, Mr Speaker, the report
0:10:31 > 0:10:34today says about the many good things that are going on. As he's
0:10:34 > 0:10:38already said, some of the things we have already taken forward with the
0:10:38 > 0:10:42green paper. While we are taking this about, remember that this is
0:10:42 > 0:10:53about the health, I'll leave it at that, it's about the health of the
0:10:53 > 0:10:56young people that we are present in England.Jeremy Quin.The CQC has
0:10:56 > 0:10:58recommended that Ofsted should be charged with looking at what schools
0:10:58 > 0:11:01are doing to support mental health, is that something that the Minister
0:11:01 > 0:11:04will take up with his colleagues in the DfE?I'm sure my colleague, the
0:11:04 > 0:11:07Parliamentary undersecretary for mental health, will be taking that
0:11:07 > 0:11:11up as she considers responses to the green paper, but I thank him for
0:11:11 > 0:11:15raising that.What action will the Minister take with increasing
0:11:15 > 0:11:18numbers of university students having mental health problems to
0:11:18 > 0:11:22ensure better joined up care and better communication between home
0:11:22 > 0:11:28and university GPs and student welfare services?Is a former
0:11:28 > 0:11:31Student Union president, I think that's a very, very good point. One
0:11:31 > 0:11:35of the key proposals in the green paper is about the new mental health
0:11:35 > 0:11:39support teams. I think they will be very important in that, she is right
0:11:39 > 0:11:42that they should work across higher education as well is the earlier
0:11:42 > 0:11:48forms of education.In the next few weeks, work will begin on
0:11:48 > 0:11:52construction of the new mental health residential unit for young
0:11:52 > 0:11:55people in Cornwall, something that is long overdue and much
0:11:55 > 0:11:59anticipated, a clear sign that this Government is investing in mental
0:11:59 > 0:12:03health for young people, but we continue to have a problem with our
0:12:03 > 0:12:05CCG in delivering front-line services even though the Government
0:12:05 > 0:12:10are providing more money. What steps can ministers take to ensure that
0:12:10 > 0:12:14CCGs allocate the money provided to those services?I don't know the
0:12:14 > 0:12:19specific example that he raises but he may wish to take that up with my
0:12:19 > 0:12:21colleague, the Prime Minister is about -- parliamentary
0:12:21 > 0:12:27undersecretary. There is an increase in CCG mental spend between 15-16
0:12:27 > 0:12:31and 16-17, we have all been frustrated about spend reaching the
0:12:31 > 0:12:36front line and made it clear that we expect it to do so. I'm pleased that
0:12:36 > 0:12:43we see progress in the right directory.Norman Lamb.Thank you,
0:12:43 > 0:12:48Mr Speaker. These damning findings come three years after we secured
0:12:48 > 0:12:54£1.25 billion extra over a five-year period. We know that that money has
0:12:54 > 0:12:59fallen short, well shot, of what was committed to three years ago. Will
0:12:59 > 0:13:02the Minister absolutely commit to make good the shortfall of money
0:13:02 > 0:13:10getting through to children's mental health services?I think our former
0:13:10 > 0:13:13-- I thank our former ministerial colleagues about. We have not
0:13:13 > 0:13:17exactly been shy in investing in this area, both when he was a
0:13:17 > 0:13:21Minister in the department and now. We have made £1.4 billion available
0:13:21 > 0:13:25to support the transformation of services and the extra £300 million.
0:13:25 > 0:13:29When he says this damning report, let's remember, this is a report
0:13:29 > 0:13:32that we commission. We don't hide from these things. The last time
0:13:32 > 0:13:38that I responded was about a CQC report into social care, we mustn't
0:13:38 > 0:13:43not hide and we don't want to bury our heads in the sand. We've got to
0:13:43 > 0:13:46recognise and built on the example is of good person centred care that
0:13:46 > 0:13:49are taking place in our country at the moment. That's why we are
0:13:49 > 0:13:56putting the money and behind it, and he's right to raise it to.Luke
0:13:56 > 0:14:01Graham.Thanks, Mr Speaker. I welcome the funding that is coming
0:14:01 > 0:14:04from my honourable friend. I ask him what he is doing to support the
0:14:04 > 0:14:09devolved nations in this area such as Scotland, where adolescent mental
0:14:09 > 0:14:12health waiting times targets were actually missed? We want to make
0:14:12 > 0:14:16sure that no British child is left behind, no matter what part of the
0:14:16 > 0:14:20UK they live in.Excellent point. I will make sure that my colleague is
0:14:20 > 0:14:24talking, as I know she is, to the devolved administrations as she
0:14:24 > 0:14:27continued as the responses, and I'm sure she will include the responses
0:14:27 > 0:14:31from them in the green paper.
0:14:31 > 0:14:34And the review found that children are waiting until 18 months to
0:14:34 > 0:14:38receive treatment for their mental health conditions. Then Lewisham,
0:14:38 > 0:14:43the budget is being cut by 5% by the government. The Green paper will not
0:14:43 > 0:14:46help children currently waiting, what is the government going to do
0:14:46 > 0:14:53address this?We will put the money in publishing sensible strategy in a
0:14:53 > 0:14:57green paper, consider the responses and take it forward backed by the
0:14:57 > 0:15:00investment that we think we need in order to deliver that strategy and
0:15:00 > 0:15:05that will be dissimilar Lewisham added will in Winchester. I'm sure
0:15:05 > 0:15:10both sides of the House will welcome the commitment to 21,000 more people
0:15:10 > 0:15:14in mental service provision by 2021. Can the Minister assure me that only
0:15:14 > 0:15:17two more children accessing mental health services within the week
0:15:17 > 0:15:28target? We talked about the four week pilot target in the testing
0:15:28 > 0:15:32idea, one of the key pillars in the Green paper and we hope to pilot
0:15:32 > 0:15:36this in order to test the impact of the additional investment we are
0:15:36 > 0:15:38making in reducing waiting time and assessing the benefits and
0:15:38 > 0:15:42challenges and to provide information on to how the waiting
0:15:42 > 0:15:45time standard should be adapted so there are no perverse assessments
0:15:45 > 0:15:51are own thresholds.The Minister has described the provision and it will
0:15:51 > 0:15:54not be recognised by anyone providing using services, does he
0:15:54 > 0:15:57think cutting the funding for the Northwest partnership every year
0:15:57 > 0:16:00since 2011 has led to improve services for young people in St
0:16:00 > 0:16:05Helens? I don't know about the issue in St Helens, so let me look into
0:16:05 > 0:16:11that and as my colleague to do so and I will get her to write to him.
0:16:11 > 0:16:14I very much welcome the government's committing mental health workers
0:16:14 > 0:16:20throughout England's schools, can my honourable friend give the House and
0:16:20 > 0:16:29update on the timely roll-out of that?One of the things that we will
0:16:29 > 0:16:32be considering as part of the Green paper is the four week pilot as I
0:16:32 > 0:16:40said. We do want to see these mental health people in schools and us as
0:16:40 > 0:16:43we can get an exact timetable on things in Crawley as well as the
0:16:43 > 0:16:49rest, I'm sure my colleague will do so. 75% of mental health problems
0:16:49 > 0:16:53start before the age of 18 but less than 10% are funding goes to young
0:16:53 > 0:16:57people. What can the Minister did to prioritise more funding for these
0:16:57 > 0:17:03services. Went back as I have said, the overall budget is the money we
0:17:03 > 0:17:07have promised around the green paper but he is absolutely right, with the
0:17:07 > 0:17:11green paper, it has at its heart, focuses on prevention and
0:17:11 > 0:17:15significant support through schools early years and through schools and
0:17:15 > 0:17:18as a honourable Lady mentioned through higher education to prevent
0:17:18 > 0:17:24issues from snowballing in the first place and is absolutely right.With
0:17:24 > 0:17:30the understanding of mental health services and the recent health
0:17:30 > 0:17:34committee Select Committee report on the nursing shortage, does he accept
0:17:34 > 0:17:37that the decision to remove nursing bursaries, which has vertically
0:17:37 > 0:17:41affected a number of students coming forward a train to be mental health
0:17:41 > 0:17:45nurses was a mistake by his government? I don't accept that was
0:17:45 > 0:17:51a mistake, I think we need to increase the number of people coming
0:17:51 > 0:17:54into nursing and we were turning away far too many people who wanted
0:17:54 > 0:17:59to come into nursing the workforce is always a huge challenge across
0:17:59 > 0:18:03the NHS in my area and primary care and secondary care and in mental
0:18:03 > 0:18:07health, which is why the secular state said we will be creating
0:18:07 > 0:18:1121,000 new posts by 2021 to support one of the biggest expansion in the
0:18:11 > 0:18:18mental health services in Europe. The Minister will know from his own
0:18:18 > 0:18:20background that primary care doesn't always have the expertise in mental
0:18:20 > 0:18:25health that we need. How will the guarantee we will now see in every
0:18:25 > 0:18:32GP surgery the capacity to deliver excellence.Gets a good point which
0:18:32 > 0:18:38is very much in the centre of my portfolio. I would say that GPs are
0:18:38 > 0:18:41generalists and as the Minister for cancer there is criticism about
0:18:41 > 0:18:45their specialism in that and GPs can't be specialists by the very
0:18:45 > 0:18:51nature by what they do. The mental health support team at the heart of
0:18:51 > 0:18:54the green paper are a key part of that and we would expect to see them
0:18:54 > 0:18:59working closely with GPs and the Royal College to upscale our general
0:18:59 > 0:19:03practitioners as part of the MDT to help young people when the need that
0:19:03 > 0:19:10help.I will be meeting with the chief executive of my local mental
0:19:10 > 0:19:14health trust tomorrow because we are desperately worried about the mental
0:19:14 > 0:19:18health budget provision for young people in your. Not only are we
0:19:18 > 0:19:22short on staff but also resources. It takes time to treat mental health
0:19:22 > 0:19:25staff, so what of the government going to do in the interim to ensure
0:19:25 > 0:19:32we have staff in the service?I hope when she meets in her constituency
0:19:32 > 0:19:36tomorrow she will recognise the good work that is going on and the number
0:19:36 > 0:19:39of people that are going over and above to deliver the services to
0:19:39 > 0:19:44children and young people I will also said at one of her
0:19:44 > 0:19:48responsibilities as a member of Parliament as ministers as well to
0:19:48 > 0:19:51see that the STPs in her area collaborating with all the different
0:19:51 > 0:19:55organisations in her constituency is to make sure its original health and
0:19:55 > 0:19:59social care services are joined up with schools, police, probation
0:19:59 > 0:20:03services and mental health services because it is ultimately one NHS.
0:20:03 > 0:20:12Will the Minister listen carefully to the voice of parents. In my
0:20:12 > 0:20:15experience as chair of the autism commission, what parents want,
0:20:15 > 0:20:18everything think there's something wrong with their child whether it is
0:20:18 > 0:20:21mental health or autism, they want early diagnosis and treatment. That
0:20:21 > 0:20:28is what they want and we want the standard like we have in Sweden.I'm
0:20:28 > 0:20:31aware of the honourable gentlemanin the Westminster commission for
0:20:31 > 0:20:34autism and has a big event coming up which I'm hoping to come to in the
0:20:34 > 0:20:39next few weeks. That's why the CDC report highlighted the government
0:20:39 > 0:20:41proposals such as establishing a dedicated mental health support
0:20:41 > 0:20:50team. I completely agree with him. Mr Speaker, phase one of the sea QC
0:20:50 > 0:20:55review noted that there were an acceptable -- unacceptable
0:20:55 > 0:20:58variations in quality, so he can quality be more consistently
0:20:58 > 0:21:06provided across the country?An excellent point, the NHS is very
0:21:06 > 0:21:09good at sharing best practice, the challenge comes at implementing it
0:21:09 > 0:21:16and the report rightly says there are very good examples of good care
0:21:16 > 0:21:20going at on across the country and the challenge is to make sure that
0:21:20 > 0:21:23is ruled out everywhere. What I would say the answer to doing that
0:21:23 > 0:21:27is to focus on the workforce, to focus on the investment and to focus
0:21:27 > 0:21:32that we have the strategy, the agreed strategy in place that takes
0:21:32 > 0:21:36the sector with it in order to do that.