NHS Funding Bill (Money Bill) — House of Lords, 2020-02-26
Topic: Health
Sheila Clare Hollins (Crossbench, Unknown): My Lords, I remind the House of my presidency of the Royal College of Occupational Therapists, and my other interests in the register. The Royal College of Occupational Therapists and several other charities have published the Community Rehabilitation: Live Well for Longer report and are calling for improved community rehabilitation for everyone who needs it. I was therefore very pleased that the Minister spoke of the Government’s commitment to treat people in the right place at the right time, with investment being made in integrated care locally. This is essential to improve rehabilitation for both physical and mental health long-term conditions and to avoid unnecessary admissions One area of the NHS funding settlement that has been widely welcomed is the commitment to increase overall spending on mental health by at least £2.3 billion by 2023-24. I will focus my remarks on this area. This is backed up by a commitment that every local clinical commissioning group will increase the amount it spends on mental health every year. As a psychiatrist, of course I welcome this increase in spending on mental health. However, as a specialist in learning disability, I am concerned that there seems to be no similar commitment to increase funding for helping this group of patients or for research in this area The Government announced that they spent £12.5 billion on combined mental health, dementia and learning disability services in England in 2018-19. However, the commitment to increase year-on-year spend seems to apply only to mental health. Could the Minister clarify this? In fact, it is impossible to know how much local areas are spending on dementia and learning disability because they publish only combined figures. I would welcome some guidance on the action being taken to ensure investment in learning disability and dementia. We cannot see the breakdown, but we know that NHS England has access to more detailed figures. Every CCG is audited by NHS England to make sure it has met the mental health investment standard—the rule that says that each CCG must increase how much it spends on mental health every year. Here is the conundrum The Royal College of Psychiatrists provided a helpful briefing for this Second Reading and highlighted that all 195 CCGs were confirmed as having met the mental health investment standard. That sounds really good, but is it not then rather confusing to learn that, last year, 32 CCGs—16.4% of the total number—reported that they had reduced how much they spent on combined mental health, learning disability and dementia services? I emphasise that every one was told that it had met the mental health investment standard. It appears that they must have achieved this by significantly cutting how much they spent on learning disability and dementia. Could the Minister confirm whether this is the case, or whether there is any other reason for a cut in overall spending The long-term plan commits the NHS to increasing investment in intensive, crisis and forensic community support for people with a learning disability and to take action to tackle the causes of morbidity and preventable deaths in people with a learning disability and autistic people. I declare my chairmanship of the oversight panel to review the care of people in this group, who are being detained in segregation under the Mental Health Act, often because of a lack of integrated community services The Royal College of Psychiatrists has called on the Government to require every CCG to publish a detailed breakdown of how much it spends on each of mental health, learning disability and dementia services so that the public can have a better understanding of what is happening. Will the Minister agree to look into to this? I particularly appreciated the comments of the noble Lord, Lord Willis, about the number of psychology graduates and simply comment that much more could and must be done to enable these graduates to get the further training they need to be able to work in healthcare.