Health and Care Bill — House of Commons, 2021-11-22
Topic: Law and Crime
Anne Marie Morris (Conservative, Centre-right): I thank the Minister for the time he gave me to consider my amendments, which we discussed in some detail, and I thank Her Majesty’s Opposition who, very kindly, took some of my amendments through Committee, sadly unsuccessfully. Tonight I hope to have the opportunity myself to explain why these amendments are so important. Before the House thinks, "Oh my goodness, how can we possibly deal with that many clauses and amendments?" let me say that I will endeavour to be brief. I rise to speak to new clause 33, and amendments 21, 22, 19, 16, 17, 20, 18 and 23—but I will be brief Let me divide my remarks into four topic areas: domestic abuse, mental health, access to medicines, and research. New clause 33 deals with domestic abuse. That is a horrific crime. It is insidious, it is hidden, and it is on the rise, and during the pandemic it has, sadly, grown from strength to strength. I say, pointedly, that this is a hidden crime, and at the moment, all the teeth are with the police. However, the police can deal only with very evident crime Where does domestic abuse first appear? It is in a doctor’s surgery, or at accident and emergency. To date, however, there is no obligation on clinical commissioning groups, integrated care boards or hospitals to come up with a strategy to address that horrific ill. New clause 33 would place a new obligation on ICBs to put in place a proactive strategy to properly manage that issue, and to introduce the education and training that GPs and those in hospitals and A&E need. We must ensure that we no longer find, as in the Safelives report, that those experiencing domestic abuse will have experienced it for three years before it is picked up, despite having already been to visit their GPs almost five times. I do not believe that that is acceptable in a civilised society such as the one we have today Five and a half per cent. of adults between 16 and 74 experience such abuse, and the Home Office has determined that the cost of that was £66 billion in 2016-17. Of that, £2.3 billion was the cost to the health service. We know that 23% of those who are at risk attend A&E, and yet nothing happens. I am fortunate that in Devon we have a pilot. My CCG is the only one in the country to have a dedicated individual on the board who specifically oversees and sets a dedicated strategy on this issue. The estimate from the pilot so far reckons that if we spent £450,000 a year on our GPs in Devon, we would get a return of £7 million. But this is not about money; this is about what is the right thing to do. Until this measure is on the statute book, and until there is an obligation to put in place a strategy, this will not change, and I cannot sit here and accept that. Let me turn to mental health. For many years and in many documents, we have seen a commitment to parity of esteem, but I have been through every statute on the book and at no point is there any reference to the words "parity of esteem for mental health". If parity of esteem for mental health is not on the statute book, how can we say we believe in it? If it is not on the statute book, how can we possibly measure it? Currently, there are very few measures of inputs or outputs—or, worse, of outcomes —for those going through the mental health system. There are some, but they are minuscule compared with what we have for physical health Amendment 23 to clause 19 would require each ICB to compare the inputs and outputs on physical health and mental health. Each ICB would be required to set out: the number of patients presenting with physical symptoms and with mental symptoms; the waiting times for initial assessment in physical health and in mental health; the waiting times for treatment in physical health and in mental health; the number of patients actually receiving treatment in physical health and in mental health; and, finally, reports on readmissions. I know that Ministers do not like that level of detail, but how important is this? Without some very specific measures, it will not happen. What gets measured generally gets done Amendment 23 would also require the ICBs to report against the very few national standards that there are. At least then we would see what they were; we would shine a bright light on the fact that there are so few for mental health while there are numerous for physical health. The Secretary of State would be required to consolidate those reports into a national report, which would have to be presented to Parliament—to both the Commons and the Lords. What is there for Ministers not to like about that amendment? What is there for those on the Opposition Benches not to like about it?