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Edenfield Centre: Treatment of Patients

Volume 720: debated on Thursday 13 October 2022

I wish to notify Members that the police have launched an investigation into the allegation of misconduct at the Edenfield Centre. I therefore encourage Members to refrain from comments that may prejudice either the police’s ongoing investigation or any subsequent legal proceedings that may result from it.

(Urgent Question): To ask the Secretary of State for Health and Social Care if she will make a statement on the treatment of patients at the Edenfield Centre.

I am grateful to my hon. Friend for this important question. Like him, I have been horrified by the treatment of vulnerable people at the Edenfield Centre, which has been brought to light by undercover reporting from the BBC. There is no doubt that these incidents are completely unacceptable. The Under-Secretary of State for Health and Social Care, my hon. Friend for Sleaford and North Hykeham (Dr Johnson), has met the Greater Manchester Mental Health NHS Foundation Trust, and a number of steps are being taken.

As a matter of first priority, my Department is working with the trust to ensure that all affected patients are safe, and a multidisciplinary team has completed clinical reviews of all patients. Secondly, a significant number of staff have been suspended pending further investigation. Thirdly, the trust has agreed that there will be an independent investigation into the services provided at the Edenfield Centre. Fourthly, Greater Manchester police are investigating the material presented by BBC “Panorama”. For that reason, as you rightly pointed out, Mr Speaker, I will not be commenting on the specifics of the case. The trust will continue to work closely and collaborate with local and national partners, including NHS England, the Care Quality Commission, the police and, of course, my Department.

These are important first steps, but they are by no means the last. There are serious questions that need to be answered, especially in the light of other recent scandals. I want to put on record my thanks to the whistleblowers, to the BBC and, above all else, the patients and families who have been so grievously affected. Anyone receiving mental health treatment is entitled to dignity and respect. On that principle there can be no compromise, and this Government will work with whoever it takes to put this right.

Thank you for granting this urgent question, Mr Speaker. It has been 15 days since “Panorama” aired the deeply distressing scenes from the Edenfield Centre in my constituency, which brought tears across the country, including my own, yet we have heard nothing from the Department. The programme showed some of the most vulnerable people in society being physically abused and goaded, sexualised behaviour from staff to patients, falsifying of medical records and patients locked in isolation for months on end. Seclusion seemed to be used for the convenience of staff, rather than as punishment. All this happened while the CQC was on site and did not issue a notice; it even praised bosses.

I have received an unprecedented amount of correspondence from individuals who have worked at the Edenfield Centre in the past or families with relatives there now or in the past. They all speak of failings of leadership, along with a culture of bullying. I have spoken with the families of those featured in the programme, and they advise that they are still being blocked from contacting their relatives, who are desperate to move out of the Edenfield Centre, and some are even still in seclusion. I pay tribute to Alan Haslam, who went undercover for three months. He received a crash course and was thrown in to care for these incredibly vulnerable people, many with complex needs.

What is the Minister doing to address the issue of sufficient training levels in the NHS for those providing mental health care? Can he outline how much additional funding the Government are giving the NHS for mental health services? Will he apologise to those families for what happened at Edenfield and support my call for a public inquiry, as Edenfield cannot be trusted to mark its own homework? Finally, will he outline how he is ensuring that the correct care is being given to those featured in the programme, such as Olivia and Harley, who desperately need it, and how the families will get the justice they deserve?

I thank my hon. Friend for his further question. I know that he has met the Under-Secretary, NHS England and the trust, and has had an opportunity to ask questions. On his points on training, I suggest he has a further meeting with my colleague at the Department, who has responsibility for mental health, so that she can set out those plans.

My hon. Friend asked whether I will apologise to the patients and their families. Of course, I will do so unequivocally. It should not have happened, and it is our role as Ministers—in fact, it is the role of all those who work in the NHS—to do all we possibly can to prevent it from happening again. He asked for an independent inquiry, and I believe it does the meet the threshold for that.

Finally, my hon. Friend mentioned NHS funding. The NHS long-term plan commits to investing at least an additional £2.3 billion a year, which takes the total to about £15 billion last year, and there is an additional £10 million for winter pressure this year.

I have a terrible feeling of déjà vu because I remember standing on a previous statement on an issue such as this, and here we are again. We are talking about the most vulnerable people, who cannot tell their own story, so I want to ask the Minister, who I know cares deeply about these issues, what more we can do to provide the proactive, independent evidence by any means necessary so that we nip this sort of behaviour in the bud. We have to care for these people, and I think that the overwhelmingly decent workforce in this industry will be equally appalled about what has happened in the Edenfield Centre. Will the Minister think about independent, verifiable, proactive evidence to stop this from continuing to happen?

I thank my hon. Friend for his question, and he is absolutely right that patients and their families deserve and indeed expect the highest standards of care quality. Safe services are by no means—never, in fact— optional extras, and where there are failures to deliver to those standards, we must continue to be transparent so that we can learn and improve. Whether it is in the CQC or local trusts, I know that the Under-Secretary, my hon. Friend the Member for Sleaford and North Hykeham, will look at any and all options to improve transparency, and to make it far clearer where cases of this nature do take place. He is also absolutely right to point out that the vast, vast majority of those who work in our NHS provide the most incredible world-class care, and where they are let down by a tiny number of individuals, as they have been in this case, such people are letting down everyone who works in the NHS.

I thank my hon. Friend the Member for Bury South (Christian Wakeford) for his work with the families who have been affected.

I want to pick up on a point of clarification, if I may. The Minister mentioned in his response that the Government are putting an additional £2.3 billion into mental health. Over the last four years, 21 different Ministers have mentioned this same funding at that Dispatch Box on 67 different occasions as being spent in myriad different ways. I know that the Government are on the ropes, but this just shows that they are out of ideas and out of money.

Patients and their families rightly expect to be safe in in-patient settings. The footage of inappropriate use of restraint and seclusion, the bullying, dehumanisation and sexualisation of patients by staff, the verbal and physical abuse, mistakes over medication and falsification of records all made for extremely disturbing viewing. Each of these would be cause for significant concern, but together they point to a scandalous breach of patient safety. It should not have taken an undercover investigation to bring to light poor patient care. Why are the Government not across this?

Since “Panorama” aired, I too have received correspondence from families who have gone through similar experiences and from former staff at Edenfield who were bullied out of their jobs. What are the Government doing to tackle this toxic culture? The Government’s failure to learn from past failings, and to implement recommendations on reducing restraint, segregation and seclusion, is costing people their lives and traumatising too many patients, as evidenced in these reports. I sent a letter to the Secretary of State after “Panorama” aired. When will I receive a response? Is the Secretary of State even taking this seriously?

In 2019, the Government committed to reducing the need for restraint and restrictive intervention, yet the use of restraint has soared. Will the Government be conducting a rapid review into mental health in-patient services? What are the Government doing to tackle staff shortages, and what are they doing to ensure that patients’ complaints about their care are taken seriously? To have a “Dispatches” investigation into another trust less than two weeks after “Panorama” aired demonstrates that this is not a one-off. What are the Government doing? People are losing their lives.

Order. May I remind Front Benchers that we have set times? Please time your speech before you come to the Dispatch Box, otherwise it is not fair.

The Government are absolutely committed to ensuring that all patients receive safe and high-quality care in all settings. As the hon. Lady pointed out, we are investing more than ever before in NHS mental health services through the NHS long-term plan, which will see an additional £2.3 billion in funding per year by 2023-24.

The hon. Lady asked what work is underway. There is work under way at a national level to improve the way we safeguard patients and ensure they receive high-quality care through a new mental health safety improvement programme, which has set up new mental health patient safety networks across all regions in England. We are reviewing everyone with a learning disability and all autistic people in long-term segregation in a mental health in-patient hospital. The Care Quality Commission is introducing a new approach to inspections from next year, which will be more data driven and targeted, and we have commenced the Mental Health Units (Use of Force) Act 2018.

I can absolutely assure all hon. Members that this Government will continue to work with our partners across the NHS, social care and other sectors to consider what more action is needed to tackle toxic and closed cultures, looking at the available evidence base and, most importantly, hearing from the people affected and their families.

NHS guidance has been clear for many years that abuse of this kind, including punitive seclusion and overuse of restraint, should never be allowed, yet it has persisted, as other hon. Members have said, including at Winterbourne View, Whorlton Hall, Cygnet Yew Trees, Cawston Park and now the Edenfield Centre. There will be other places, too, that have not had media attention, but where families of patients are seeing abuse and have no mechanisms to change things.

Harley is a young autistic woman who was detained at the Edenfield Centre and experienced punitive seclusion for weeks at a time. She said in the programme:

“Staff provoke a patient and then my reaction is used against me. But they’re provoking us. It’s disgusting. I’ve been treated like I’m an animal.”

There are over 2,000 autistic people and people with learning disabilities locked in inappropriate in-patient units in this country, often for 10 years or more. The policy of the use of inappropriate in-patient units for autistic people and people with learning disabilities is a choice. They could have support in the community with skilled and experienced staff. Will the Minister promise to end the culture of abuse for Harley and so many people like her?

The hon. Lady is right. I believe what I saw to be disgusting too. She specifically referenced those with learning disabilities and autistic people in long-term segregation. NHS England is undertaking independently chaired care education and treatment reviews for everyone with a learning disability and all autistic people in long-term segregation in mental health in-patient hospitals. A senior intervenor pilot is also underway. These actions will help support people in long-term segregation to move to a less restrictive setting or to leave hospital. A programme of safety and wellbeing reviews for the care and safety of people with learning disabilities and autistic people is now complete, and NHS England will be publishing the findings of a national thematic review later this year.

Recruiting the right staff is key to providing the right mental health support. I know from conversations I have had with providers in Cornwall that they are facing a huge challenge in recruiting staff. Will the Minister lay out what steps the Government are taking to attract more of the right people to work in mental health provision?

I thank my hon. Friend for his question. We know this issue is not exclusive to mental health practitioners, and it can be a particular challenge in rural, remote and coastal areas. The Secretary of State is currently working on a workforce plan, which we hope to publish in due course. Talking more broadly about those working in mental health in the NHS, as raised by the hon. Member for Tooting (Dr Allin-Khan), we have 6,900 more mental health professionals in the workforce than in 2021, which is a 5.4% increase since then and a 12.2% increase on June 2010.

Jemima Burnage, the interim director of mental health at the CQC, described the BBC’s footage of the Edenfield Centre as “appalling, inhumane and degrading”. The people of Greater Manchester deserve better than that. Does the Minister therefore agree with local authority calls for a public inquiry?

Having seen some of the footage, it is hard for me to disagree with the words that the hon. Gentleman has used. I know that the Greater Manchester Mental Health NHS Foundation Trust has already identified and suspended staff involved in the behaviour at Edenfield that was revealed in that documentary, the police have launched an investigation into the allegations, and disciplinary proceedings have now commenced post broadcast. As I said, does that meet the threshold for an independent inquiry? My view is that it does.

As this shocking investigation shows, the Mental Health Act 1983 often leaves vulnerable people at risk of cruelty and a distinct lack of care, and too many people have endured poor treatment or been detained for many years against their wishes. Reform of the 40-year-old Act is long overdue. We had the Wessely review back in 2018 and the White Paper in 2021. When will we see legislation come to the Floor of the House so that we can finally get that overdue reform?

I thank the hon. Lady for her question. I understand that a Bill to reform the Mental Health Act is in the Lords. I cannot give her a further update on that as I am not the responsible Minister, but it is important to stress that it is part of a number of measures that the Government have taken to improve on some of the challenges that she rightly pointed out. Whether that is the use of force Act, the NHS patient safety strategy, the mental health safety improvement programme, the patient safety networks that I mentioned, the new requirement for learning disability and autism training for staff or the HOPE(S) model, a lot is going on. I know that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson), will be happy to meet her to update her further.

If a test of the Government is how the most vulnerable in society are protected, I am afraid that this is yet another failure—as has been said, this is not the first time that it has happened. The CQC inspected the trust only a couple of months before the documentary was aired, which raises serious questions about the efficacy of CQC inspections. What challenge has it been given about its findings?

I thank the hon. Gentleman for his question. As a former Children’s Minister who every week read the serious incident notification report, I am a little bit disappointed in it for one reason. I mentioned some of the steps that the Government are taking, and yes, we always need to do more, but no Government can ever legislate for or produce procedure or guidance that will stop anyone who is not acting with empathy and kindness. In this case, we have seen some of the most horrific abuse. No Government can legislate to stop that, but we must do all in our power to identify it and prevent it. The CQC has an important role in that. My understanding is that, as soon as a whistleblower brought the matter to its attention, it investigated. We then understand that there was the BBC investigation. Of course, we will look at how the CQC responded and hold it to account.

What was the earliest date on which a whistleblower or member of a family contacted either the Department or the CQC? With respect to what the Minister said about the CQC, given that we have repeatedly seen such degrading behaviour at Winterbourne View and other places, what confidence does he have that it can assure the public that care is being given at the quality that is required?

On the hon. Member’s first question, I am a little cautious only because I am not the responsible Minister, but my understanding—I have not heard this at first hand—is that the first whistleblower complaint was made around Easter. I know that the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Sleaford and North Hykeham, will write to him on the specifics about the point at which the CQC was first notified.

Is this in any way acceptable? The answer is no. Do we therefore need to look at processes and how the CQC investigated, how it acts and its ability to identify? Yes, of course we do. But, in the same way, going back to my time as Children and Families Minister, I know that when people act in a way in which they know they should not, they deliberately hide that from the authorities and investigative bodies. So we do need to cut the CQC a little bit of slack, because this is often not in plain sight. Where it is, it is easier to identify. However, the hon. Member is right that where there is a whistleblower complaint, we must act, and we must act swiftly.

We hear far too often of staff being completely overstretched, with far too many vacancies in mental health services. That was cited as one of the factors in the Edenfield scandal, but it is all too common. The Government were happy to clap for key worker staff, but they refuse to treat them with dignity and respect. Labour has pledged to invest in the NHS mental health workforce. We will recruit 8,500 extra staff. Why will the Minister not make the same commitment?

We are absolutely fully committed to attracting, training and recruiting the mental health workforce of the future. Through our plans set out in “Implementing the Five Year Forward View for Mental Health” and “Stepping Forward to 2020/21: the mental health workforce plan for England”, we have expanded and diversified the types of roles available. The hon. Lady asks us for our plans. Our aim is an additional 27,000 mental health professionals in the workforce by 2023-24 to deliver the transformation of mental health services in England that we all want to see.

I thank the Minister for his answers, and I welcome him to his place. Having seen a very similar issue with the treatment of vulnerable patients in Muckamore Abbey Hospital in Northern Ireland, it would appear that how we balance the safety of staff with the treatment of patients needs an overhaul, and that must be UK-wide. Will the Minister make contact with the devolved Administrations, in particular the Northern Ireland Assembly, to ensure that lessons learned can be lessons shared for the safety of patients, but also for staff who have to deal with these things throughout the whole of the United Kingdom of Great Britain and Northern Ireland?

The hon. Gentleman is absolutely right. There is no monopoly on best practice and where it does exist, we have to ensure it is shared. Where we identify the very poorest practice, we must ensure the lessons are learnt not just in England, but across our United Kingdom.