The NHS Long Term Plan: Lots to welcome, lots to worry about.

On January 31st I spoke in a debate on the NHS Long Term Plan, which was published in January . While I think there is much to welcome in the plan I also express my worries over areas the plan is silent on. You can read my speech in this debate here and watch the debate here.

One area I particularly worry about is whether the NHS will be able to recruit the workforce to deliver the Long Term Plan. For example, we will need to find over 20,000 extra mental health staff in order to achieve the goal that 100% of children with mental health will be able to access treatment over the next decade. This is why I  questioned the government over whether it would fund a “Mental Health” careers campaign aimed at secondary school and University Students to help plug this hole. You can watch me ask this question here and read it in Hansard here.

“However, there is also much to worry about—mainly things about which the plan is silent. The NHS does not operate in isolation, and I am concerned—like many other noble Lords—that many of the laudable aims of the plan are being directly undermined by cuts elsewhere to public health and social care budgets.”


Supporting Action for Children’s Build Sound Minds Campaign

BSM event – Claire Tyler (30-01-19)

On the 31st January 2019, I joined young people and mental health experts from leading charity, Action for Children, to support the parliamentary launch of Build Sound Minds – a campaign to help children and teenagers build good mental and emotional wellbeing.

It is clear that Children’s Mental Health support needs radically improving. According to Action for Children, a third of 15 to 18-year-olds they assessed were found to be suffering from mental health issues. Pupils in need of support have been taking part in the Blues Programme, the first ever UK-wide early help intervention for teenage depression. Given my work on Children and Young People’s Mental Health, I was

Ahead of Children’s Mental Health Week (4-10 February),  I pledged support for the charity’s campaign, which aims to improve children and teenagers’ mental health by providing families with accessible information, tools and tips. To find out more about the campaign, you can visit their website here or follow them on Twitter at @actnforchildren.


“What gets measured gets done”: The Social Metrics Commission’s new Poverty Measure

On the 21st of January 2019, I spoke in a debate on a recent report by the social metrics commission, which has developed a new measure of poverty. I was very pleased that this measure of poverty takes into account the total resources of an individual instead of simply focusing on income as many previous measures have.  This is why I have encouraged the Government to adopt this measure as their official measure of Poverty.

You can read my speech here and watch me speak on parliament live here.

“The measurement of poverty has for too long been a hot potato, with too much time being given to arguing about how and whether to measure poverty and not enough time devoted to taking action to reduce it … I hope that this measure is adopted by political parties and campaigners, but above all by the Government as their official measure of poverty, so that they can put in place meaningful policies to reduce poverty and address the plight of those who suffer from it.”

Battling for Access: Children and Young People’s Mental Health Services

To mark Children’s Mental Health Week, I wanted to reflect on the work I have been doing recently to highlight the battle many young people face to access mental health support.

On the 30th of January, I led a dinner hour debate on the topic of what assessment the Government has made of the recent concerns expressed by general practitioners that children and young people with mental health problems are unable to access National Health Service treatments; and what steps they will take to address them. I arranged this debate following a recent article in the Guardian, which revealed that a staggering 99% of GPs feared that under-18s would come to harm as a direct result of delays in their mental health care. You can read my speech from this debate here or watch it on parliament live here.

I have also been blogging about the worrying delays to children’s mental health treatment in Politics Home and the Lib Dem Voice.

“Seventy years after the creation of the NHS, families should not be forced to pay for the mental health care that their children so desperately need.”

Overlooked and Left Behind

Yesterday I made a speech in the House of Lords on Social Mobility. Below is a short extract. You can find my speech in full here.

Just over 18 months ago I proposed The Lords Select Committee on Social Mobility. It published its report in April this year, entitled “Overlooked and left behind: improving the transition from school to work for the majority of young people”. I believe this title still says it all. Those young people not pursuing either higher education or apprenticeships – that is, just under half of them – face a system beset by a lack of funding, esteem, guidance and co-ordination. The current system isn’t just unfair on the individual young person, often leading to a life time of missed opportunities. It also damages the UK’s economy and limits our collective human capital. Investing in our young people today has significant long-term economic and social value tomorrow, but only if we get the system right for all.

It’s long overdue.

Lack of Progress on Parity of Mental and Physical Health

On Tuesday, I made a speech in the Lords lamenting the lack of progress in achieving parity of esteem between mental and physical health. I called on the Government to address the underfunding of mental health services and the underlying cultural issues that lie at the heart of the problem.

I asked the Government why in the Autumn Statement there was funding for the expansion of grammar schools but not a penny for the NHS. I await their reply with interest.

You can find my speech in full here.

The fundamental question for us is why it has been so difficult to achieve real and sustained progress. I did a quick survey of the scene, and many aspects I did not find very reassuring. As Michael Marmot so powerfully reminded us in his recent book The Health Gap: The Challenge of an Unequal World, people with mental ill health have a life expectancy between 10 and 20 years shorter than people with no mental illness. I am sure we all find that shocking.

Only a quarter of those with mental illness such as depression are receiving treatment, a figure that contrasts with 78% of those with heart disease and 91% of those with high blood pressure. A recent CQC report noted that, when facing a crisis, a shocking 32% of people do not know who to contact out of hours. Indeed, 24% of those who did know said they did not receive the care they needed.

As we have already heard, last year, across the board, 40% of NHS mental health providers had their funding reduced, despite NHS England instructing commissioners to increase it. This raises serious questions as to whether funding is reaching the areas where it is most needed, and it highlights the damaging impact of the Government’s refusal to ring-fence mental health funding. I know Jeremy Hunt said that he does not have the power to do that, but frankly, Governments, if they are so minded, can do something about it if they do not have the powers.

It is the same story with the £1 billion announced last year for mental health, much of which does not come on stream until the end of this Parliament. One could be forgiven for assuming that in last week’s Autumn Statement, the Chancellor would have offered a lifeline to mental health services, as well as other areas of health and social care. Instead, the Government found £240 million for the expansion of grammar schools, but not a penny for the NHS.




Success: Pilots of Mental Health Assessments for Children Entering Care

Last week, the Government announced plans to begin pilots to extend the current physical health assessments to cover mental health for children entering care. In the last few months I have been fighting for this amendment and am delighted that following discussions with Ministers at the Department of Education this important change will go ahead.

I made a speech thanking the Minister for the Government’s response and welcoming the introduction of the pilots. You can find my speech in full here.

I recently wrote an article for the Liberal Democrat Voice regarding the success of this campaign – the article is available here.

I am very encouraged by and was grateful to hear the commitment that he made today at the Dispatch Box, announcing that there will be, I think he said, between six and 10 pilots starting in April or May next year, to test out new approaches to mental health assessments for children in care. As he said, this will happen in parallel to the valuable and important work of the expert working group. I consider this to be a really important step forward, so I am very grateful to him and I look forward to making any contribution that I can to the development and implementation of these pilots. I thank him and all noble Lords who have participated in this discussion and I will say again how pleased I am by this progress. I beg leave to withdraw the amendment.

Report: Schools Can Make Huge Difference to Children’s Mental Health

On the 16th of November, I asked for the Government’s response to the Values-Based Child and Adolescent Mental Health System Commission ‘What Really Matters in Children and Young People’s Mental Health’.

I called on Government to recognise a key recommendation of the report, that schools if properly funded and supported, have the potential to make a really big difference to improving children’s mental health.

You can find my questions and the debate in full here.

Mental Health Assessments for Children Entering Care

On the 18th of October, I tabled an amendment to the Children and Social Work Bill calling for mental health assessments for children entering care.

This proposal would simply extend the scope of physical health assessments that are already in place to include an initial mental health assessment.

You can find my speech in full here.

My amendment is designed to ensure that we can achieve some practical improvements to the care that children receive. It introduces mechanisms that will ensure that the mental health needs of children entering care are properly assessed and that they have access to specialist support if this is needed. Basically, the amendment has two elements: first, a mental health assessment for children entering care, carried out by a qualified professional; and, secondly, a designated health professional in each local authority who has strategic oversight of the outcomes of the assessments and matches those with the services that are available for children in care to support their needs.

In short, this amendment seeks to establish a mechanism that will identify children’s needs early on, refer the children to the right services and ensure that services exist that children in care are able to access—and access easily. This joined-up approach is supported by the Alliance for Children in Care, a coalition of leading children’s charities, as well as the Royal College of Nursing, the Royal College of Paediatrics and Child Health, and the Royal College of Psychiatrists.

National Disgrace: Premature Deaths of People with Learning Difficulties

On the 17th of October, I made a speech in the Lords about the shocking statistics concerning premature deaths of people with learning difficulties. I called for mandatory participation in learning disability mortality review.

You can find my speech in full here.

We have already heard, from the noble Baroness, Lady Rawlings, the shocking statistics that men with learning disabilities die, on average, 13 years sooner than men in the general public and women with learning disabilities die 20 years sooner. Overall, 22% of those people were under 50 when they died. These are not just dry statistics, they are deeply shocking and nothing short of a national disgrace. Perhaps the most shocking statistic of all is the confidential inquiry’s finding that 37% of deaths were potentially avoidable if good quality healthcare had been provided.

As we have already heard from the confidential inquiry, one of the 18 key recommendations was the establishment of a national learning disability mortality review. A key part of the review programme, commissioned again by NHS England, is to support local areas to review the deaths of people with learning disabilities and take forward the lessons learned to improve services. I am sure we all think that is what should happen. So far, so good. However, as has already been referred to by the noble Baroness, Lady Hollins, participation in the programme is not mandatory, so, unlike the child death review process, and, indeed, many other inquiries, agencies can choose whether or not to contribute to the review of deaths of people with learning disabilities. In the current financial climate, I guess it is understandable that many organisations choose to do only what they have to. In my view, giving this issue mandatory status would undoubtedly raise the profile of the work and show that the lives and deaths of people with learning disabilities are valued. That is the crux of what we are talking about tonight.