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House of Lords Hansard

Mental and Physical Health: Insurance

12 September 2017
Volume 783

    Question

    Asked by

  • To ask Her Majesty’s Government what steps they are taking to ensure that mental and physical health conditions in the health insurance market are treated equally.

  • My Lords, in asking this Question, I draw attention to the fact that I have a personal interest.

  • My Lords, it is for private health insurers to decide the cover they offer for different types of conditions. However, the Government are determined that insurers treat customers fairly. Under the requirements set out by the Financial Conduct Authority, consumers should be widely protected, including in the health insurance market. Furthermore, where a condition is classed as a disability, equalities legislation places specific obligations on insurers to prevent unlawful discrimination.

  • My Lords, I am grateful to the Minister. This is a Question not about private health provision for individuals but about cover for primary care professionals indisposed by illness or accident, where alternative staffing is required. Does he agree that it is totally unacceptable for a policy to be enunciated or, as in this case, unilaterally altered so that requirements for the practice entail, where stress or mental health is concerned, a psychiatrist and/or a consultant psychologist to be engaged within the first eight weeks in relation to cover? It is not only impractical but impossible to fulfil such a requirement, it is totally against normal clinical practice, and it clearly engages discrimination against those suffering from stress or mental ill health. Will the Minister consider asking the brokers’ association to issue a code of guidance so that insurers of this kind are not taken on in the future?

  • I am very grateful to the noble Lord for his characteristic courtesy in giving me advance notice of the context of the Question he raised today. Although the situation he describes would obviously cause concern, I remind him, as I said, that the Financial Conduct Authority—the regulator of the insurance brokers and potentially of the insurance company—has certain duties under the FCA rules, but also under equalities legislation, to behave in an appropriate way in these matters. Where there are complaints, there is a route to take the matter up not only with the FCA—and I encourage the noble Lord to make these facts available to it—but with the financial ombudsman.

  • My Lords, some 20% of GPs suffer from depression at some time during their careers, yet GPs rarely take time off work because of course they know that their colleagues have to cover for them; there just does not seem to be any provision. Does the Minister accept that the growing number of GPs who are retiring early, or who are cutting the number of sessions they work, could be greatly eased if doctors’ mental as well as physical ill health were properly dealt with? Despite the comments that he has already made, I ask him to take this very seriously in view of the incredible crisis in general practice because of the diminishing numbers of GP hours being worked.

  • While we recognise the great service and the demands placed on GPs and their practices in this regard, most people who seek support, particularly for mental health issues, are not necessarily going through private healthcare providers but seeking it through the NHS and through GPs themselves. That is why it is important to put on record that the funding going into mental health services within the NHS is at record levels—it is now at £11.6 billion—and we have the Five Year Forward View for Mental Health, under which that figure will grow year on year. That is not to be at all complacent; we are very mindful and cognisant of those important strains and how they are responded to.

  • My Lords, I am just back from Bhutan, a constitutional monarchy that has only been in existence for nine years and needs some help with the development of democracy. However, the noble Lord, Lord Layard, went there a few years ago after his book Happiness and the king welcomed him on the basis that this was part of the constitution of Bhutan—one of their key issues is increasing support in the area of mental health. I hope that the Minister will convince us all that the Government gives similar priority to mental health in this advanced country.

  • First, welcome back. It is good to see the noble Lord in his place. I do not know how long he was away in Bhutan, but there has been quite a bit of movement in this area in recent years. The Health and Social Care Act, led through this House by the noble Earl, Lord Howe, played an important role. It introduced parity and this was a significant advance. The serious discussion in the media now about mental health issues—particularly among young people—and how we respond to them, and the resources which are moving into this, bode well. As to whether we will match the constitution of Bhutan, I can say that parity of esteem is now in the constitution of the NHS.

  • My Lords, is there any evidence that insurers are dealing with treatment for mental health differently from that for physical health? How many instances have there been, say over the last three years, of complaints about parity to the Financial Ombudsman Service and what were the outcomes?

  • I do not have those specific figures to hand. The data on such experiences would be obtained through the Financial Conduct Authority. The Question asked by the noble Lord, Lord Blunkett, shows the importance of raising awareness of insurers’ responsibility to treat their clients equally, as set out under the Equality Act 2010. If people do not feel they have been treated fairly, they should seek redress.