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Mental Health: Spending

Volume 751: debated on Monday 27 January 2014


Asked by

To ask Her Majesty’s Government why they have discontinued the annual survey of mental health spending.

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and refer noble Lords to my entry in the register of interests.

We stopped commissioning the national surveys of investment in mental health services in 2012 to reduce bureaucracy in NHS organisations and local authorities. NHS England will publish data on mental health spending in 2012-13 this year. We are currently working with NHS England, NHS stakeholders and partner organisations to review how mental health data are collected and presented to make them more useful and meaningful for commissioners, including in how to identify priority areas such as IAPT and dementia specifically.

My Lords, first, I welcome the noble Baroness to her first Oral Question on health. Is it not a fact, however, that the annual survey showed that, far from parity of esteem, the proportion of money going to mental health services has reduced in the past two financial years? Is that not why the survey has been discontinued? Will she give orders to NHS England to start producing the survey again to ensure that there is, in fact, parity of esteem for mental health services?

The noble Lord is absolutely right: parity of esteem is critical. The Government are very intent on holding NHS England completely to account on parity, which is woven into the NHS outcomes framework and the mandate. As I said in my Answer, the Department of Health is working very carefully and closely with NHS England to determine what the most appropriate data are to ensure that patient care is maximised.

My Lords, I, too, welcome my noble friend to her first Question Time. I welcome what she says about the department working with NHS England in order to have the most useful way of bringing figures together. It is not a question of having figures for the sake of them. Can I seek her reassurance that those discussions will include finding a way not just of measuring psychological treatments against other treatments in mental health, but of ensuring that the range of psychological therapies is measured and available, so that we can indeed see whether there is an improvement in the situation?

My noble friend has much experience and expertise in this matter. He will know that NICE has recommended in its guidelines a whole range of psychological therapeutic interventions. Available therapies include interpersonal therapy, brief dynamic interpersonal therapy, couple therapy for depression, counselling for depression and behavioural family therapy, as well as cognitive behavioural family interventions. These therapies are all delivered by IAPT services and are included in IAPT training. Since 2010, more than 1,000 therapists have been trained or are currently in training. With regard to new therapies, I assure my noble friend that the IAPT programme will consider evidence-based therapies recommended by NICE for anxiety and depression as they arise.

My Lords, does the Minister agree that the first step in developing and delivering effective mental healthcare services is the collection, analysis and dissemination of high-quality data that managers, practitioners and service users can understand, and that, without these, service development will be severely hampered? A case in point is the Count Me In census, which for five years collected high-quality, focused and detailed information on services for minority ethnic mental health patients. The Government did what they are doing again now—that is, incorporating that data collection system into a wider system. An invaluable tool has effectively been lost and that has severely hampered service development in this area. Can the Minister assure me that this data collection system will be brought back into this area of work?

My Lords, the noble Lord, Lord Patel of Bradford, is another expert in this field. It is important to keep information about types of mental health conditions and about the ages involved. Currently, data on age are not collected; there is only information on what category people fall into. There is some merit in looking at ethnic background. I have no briefing on that but it may be sensible if I talk to my honourable friend Norman Lamb and ask whether he can have a conversation with the noble Lord about that.

I also welcome the noble Baroness to the Front Bench for Questions. Can she confirm that the data collected will cover child and adolescent mental health services and the outcomes from the different interventions in that age group? Those in that group are particularly vulnerable and there are many influences on them, from both education and their social background.

Child and adolescent services are certainly critical. The Government have put £54 million into child and adolescent IAPT services, and IAPT waiting times are being looked at slightly differently. Those services will be provided in two stages. The first stage will involve not just the first appointment but an agreed programme of care. The second stage is that a second appointment has to be in the book within 28 days of the first appointment. We have looked at trying to make the waiting times slightly more rigid and non-virtual. I emphasise the Government’s concern about child and adolescent services.

My Lords, between 2011 and 2012 home support services saw a decrease of some 5.5% in expenditure. Can the noble Baroness tell us what impact this is likely to have on the mental well-being of people living with dementia and their carers? How can this impact be monitored if detailed spending figures are not yet available?

Dementia services are delivered jointly with social care. The Government will be working with NHS England through clinical commissioning groups to make sure that the joint strategic needs assessments that are set out in local plans include provision for people living with dementia. My honourable friend in the other place has set up pioneering groups that are looking at integration of services. All that is very high on the agenda.

My Lords, I return to the original Question, asked by the noble Lord, Lord Hunt of Kings Heath. Is my noble friend telling your Lordships’ House that the figures for the past two years do not exist in the keeping of any health organisation? Or is she telling us that they do exist but the Government will not instruct that organisation to publish them?

My Lords, the last figures kept by the Government were the Department of Health ones for 2011-12. The figures for 2012-13 and 2013-14 are being kept by NHS England.