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Health: Eating Disorders

Volume 801: debated on Tuesday 7 January 2020


Asked by

To ask Her Majesty’s Government what steps they are taking following the reported rise in hospital admissions for eating disorders.

My Lords, the latest figures show that young people with an eating disorder are getting more of the support and treatment that they need than ever before. As part of the NHS long-term plan’s investment of an extra £2.3 billion a year by 2023-24, eating disorder services are being ramped up across England. This is on top of the £30 million each year announced in 2014, supporting 70 teams delivering care to thousands more young people with eating disorders.

NHS figures show that 19,000 people required hospitalisation for eating disorders in England last year. That figure is more than double what it was a decade ago. With only 649 in-patient beds in the NHS in England to treat people with eating disorders, does the Minister agree that the resources to tackle this worrying mental health crisis are too scarce?

The noble Baroness, I know, has personal expertise in this area, and I thank her for her Question. As she knows, we have taken seriously trying to expand and improve eating disorder services in the country. We have invested the extra £30 million in community care and introduced the new waiting time standard, which we are on target to meet. But she is right to say that we need to improve in-patient care as well, and we are working hard to deliver on that.

My Lords, in view of the key role of schools in responding to mental health issues such as eating disorders, what progress have the Government made in giving schools the vital training support that they need in this area?

My noble friend is right that schools are important if we are to deliver on our commitment to the earlier diagnosis and prevention of mental ill-health, particularly in the area of eating disorders. We are introducing new school and college-based mental health support teams, the first of which are now becoming operational. We are also piloting four-week waiting times in 12 areas to improve access to children’s and young people’s specialist mental health services, which link to those schools, and we will evaluate performance on that.

My Lords, can the Minister confirm that in addressing the rise in eating disorders, sufficient consideration will be given to the intersection with the anti-obesity agenda? Measures to tackle child- hood obesity such as calorie counting or compensatory exercise are also symptoms of eating disorders, the very behaviours that treatment seeks to address. Many patients report that their illness started as a result of weight-related teasing, healthy eating advice or being praised for dramatic weight loss. Does the Minister agree that the solutions for eating disorders and obesity need to be considered in parallel to avoid the risk of one impacting negatively on the other?

Obviously we cannot ignore the obesity challenges that we face in this nation, and it is right that we take strong action to address them. But we recognise that this must be done in a sensitive way that also takes into account the potential consequences for those with eating disorders. We must strike a careful balance between informing and educating people about healthier choices and not negatively impacting on those with eating disorders, those in recovery from eating disorders or those who have the potential to develop them.

My Lords, the figures are, of course, of great concern but, as so often happens with many pathologies, sometimes the reasons for these sudden or increased rises are due to better diagnosis or increasing diagnosis, and, of course, greater awareness of the problem. Given that, can the noble Baroness say what plans the Government have to ensure that NHSX is fully supported in trying to help us to analyse these data to see just how important investment in this particular condition actually is, and others similarly that are on the rise?

The noble Lord, as ever, is quite right to delve into the detail of the 2017 survey into the mental health of children and young people in England. It found that eating disorders were identified in 0.4% of five to 19 year-olds—the spread was 0.7% of girls and 0.1% of boys—but it rose to 1.6% of girls aged seven to 19. Obviously, we want to understand what this rise in admissions means. There could be a number of reasons, which we hope are linked to earlier and better diagnosis, but of course we need to understand it better. We have a much better understanding of the data through the NHS mental health dashboard, which tracks down to CCG level what is happening with it, but we need to make sure that this work is properly funded and properly tracked in order to lead to better and more effective policies and provision of commissioned services.

Does my noble friend recognise that sometimes the point at which young people with severe eating disorders are able to meet the criteria for admission to an in-patient bed is so severe that some of the potential benefits from an earlier admission are lost? I ask my noble friend to return to the number of in-patient beds. We have a deficiency. What is the Government’s estimate of the extent of that deficiency, and what steps are being taken to commission additional in-patient beds?

We are increasing the number of commissioned in-patient beds up and down the country, but we are doing it in a way that recognises that it is better to have earlier diagnosis—prevention of the need to admit—and ensures that we do not wait until patients are at the stage where they need admission, which is the primary aim. My noble friend is absolutely right that we need to make sure that we have the right balance between those two. At the moment, we are doing a thorough assessment, and I will be happy to write to him on that issue.

My Lords, the Minister has mentioned early diagnosis and treatment, which will help save lives, yet doctors receive less than two hours’ training on this topic. What pressure can the Government bring to bear to improve training for this deadliest of mental health illnesses?

My Lords—[Interruption.]

I am getting some help from the other side.

The noble Baroness is quite right on this matter. It is vital that professionals are trained to look out for potential signs. Obviously, with such a deadly mental illness—

I am not sure whether to stop or carry on.

Diagnosing eating disorders is an important area of mental health practice, so Health Education England is taking forward a significant package of work at the moment to review current education and training offered to identify gaps and ensure that not only junior doctors but general practitioners and nurses have the right kind of training.

My Lords, we now come to a number of First Readings. It might be helpful to the House if Members were kind enough to switch off their mobile phones before coming into the Chamber.