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Eating Disorder Services: Referrals

Volume 812: debated on Monday 17 May 2021


Asked by

To ask Her Majesty’s Government what assessment they have made of the change in referrals to eating disorder services since April 2020.

My Lords, eating disorders are serious, life-threatening conditions. We recognise eating disorder services are facing increased demand from children and young people, with 719 urgent cases starting treatment in the fourth quarter of 2020-21. That is why we made £10.2 million of additional funding available to mental health charities, including those that address anorexia, at the beginning of the pandemic, we convened a cross-government ministerial group to publish a mental health recovery plan and we are holding a ministerial round table on eating disorders.

My Lords, Q4 data on waiting times released last week showed, as the Minister said, 719 patients starting treatment for urgent cases of eating disorders, but this compares to 353 at this time last year. At this point in 2020, 18 people awaited urgent treatment, and 543 awaited routine treatment; those numbers are now 130 and 1,404. While much has been said about the pandemic’s role in driving this spike, most studies into young people’s mental health over the last year were not designed to detect eating disorders so, beyond anecdote, the reason for this increase, and therefore the best way to address it, is not clear. What will Government do to better understand this sharp increase? Does it represent broader and lasting behavioural changes among young people? Will the Government closely monitor the impact of their obesity strategy on referral rates, given that some of the planned measures—calorie labelling on menus, for instance—are shown to exacerbate existing eating disorders and increase the risk of their development in the general public?

My Lords, undoubtedly, the increase in referrals is something of concern. It is something we are monitoring closely, with the round table and the ministerial group dedicated to looking at this. That shows the seriousness with which we regard it. The reduction in the impact of community services, which is the best way of addressing these kinds of issues, has undoubtedly had an effect on urgent needs. During this period, there has also been a large increase in the number of young people who have started treatment, which is encouraging. If the noble Baroness has evidence that measures such as nutrition information on packaging has an effect on anorexia, I would welcome correspondence from her.

My Lords, as the noble Baroness has said, we know that eating disorders among children and young people have increased during the pandemic. There is a very welcome increase in the grant of £11 million from the grant in 2018-19. Despite this, total spending by CCGs on children and young people’s community eating disorder services increased by just £1.1 million, from around £54 million in 2018-19 to £55 million in 2019-20. This increase is cancelled out if you adjust for inflation, and this means that total spend flatlined in real terms. What are the Government going to do to ensure that this money is spent on what is growing into an epidemic of eating disorders and the suffering they cause?

My Lords, the noble Baroness is entirely right that community eating disorder services are critical. They are the backbone of our measures to address these difficult cases. But money for the treatment of eating disorders comes from many different pots. During 2021, a total of 10,695 children and young people started treatment, which is up from 8,034 children in the year before. So, clearly, resources are getting through to cope with a large number of people, and that is an encouraging sign.

Is the Minister confident that all referrals to a community eating disorder specialist can be managed without excessive travel on the part of the individual and their family and that, where necessary, local in-patient services are available right across England?

The noble Baroness refers to a perennial issue in any national health service, which is the inevitable concentration of expertise in some hubs where there is particular specialist knowledge. But she is entirely right that we should try to avoid excessive travel. That is why community eating disorder services are so important, because they bring the treatment as close as possible to the people who are suffering.

My Lords, the noble Baroness, Lady Bull, is quite right to raise this important issue today. Young people have had their lives turned upside down over the last year, their plans put on hold and their prospects blighted and, with a sense that they have lost control, it is hardly surprising that we have seen a huge rise in mental health issues. Can the Minister give us an indication of the waiting rates at the moment, especially for those diagnosed as urgent cases? Is it his view that we have enough practitioners? If not, does he have any plans to discuss the need for more training and a recruitment drive?

My Lords, my noble friend puts it extremely well. Young people have been under huge pressure during the pandemic. It is a huge tribute to the young people of Britain that they have borne it so well. I do not have to hand the statistics on waiting lists that she asked for, but I would be glad to write to her with the details. We are recruiting right across the NHS at the moment; it has been an extremely successful recruitment round, and those kinds of recruits will go to services such as those dealing with eating disorders.

My Lords, to return to calorie labelling on menus in restaurants, as raised by the noble Baroness, Lady Bull, there is limited evidence for its efficacy in reducing levels of obesity, but there is clear evidence from the Royal College of Psychiatrists eating disorders faculty—and anecdotal evidence from my daughter and others—that it can be responsible for triggering those with eating disorders. Can the Minister respond to what the noble Baroness, Lady Bull, asked for and confirm that, should the Government introduce this labelling on menus, they will review its impacts not just on reducing levels of obesity but on those suffering from eating disorders?

My Lords, the eating habits of the nation have changed considerably in recent years. The amount of food that people eat that has been prepared by others has risen dramatically, and many people have no idea what is in the food they are eating. That is why we have moved to bring in calorie labelling on food that is delivered and in restaurants. I am acutely aware of the concerns of the noble Baronesses, Lady Parminter and Lady Bull. We are committed to engaging with eating disorder charities, Beat and other key stakeholders, and to listening very carefully to their concerns on this.