New Forest East



Dr Julian Lewis: Unlike the doctors who have spoken from the Conservative Benches, my hon. Friends the Members for Bracknell (Dr Phillip Lee) and for Totnes (Dr Sarah Wollaston), who spoke with such expertise, I have absolutely no medical qualifications whatsoever, but that has not stopped me giving my opinions on this subject in the past, and I am afraid that it is not going to stop me today.

I see from the index on my website that this will be the ninth speech that I have made on the Floor of the House or in Westminster Hall on mental health. Many of those speeches were supported by my hon. Friend the Member for Broxbourne (Charles Walker), and I do not think we will ever hear a finer speech than the one that he made today. In passing, I pay due credit to the hon. Member for North Durham (Kevan Jones), whose interest in these matters I have known about for a long time, although not his personal history.

The speeches that I have made in the past have tended to concentrate on three themes: the importance of separate therapeutic environments for people who have to be admitted when they are acutely mentally ill – it is obviously unwise to have psychotic patients cheek by jowl with people suffering from suicidal depression, for example; the importance of single-sex wards, particularly in mental health units, although that applies to the NHS hospital network as a whole; and the importance of making adequate bed numbers available for people who require periodic admission to a mental health unit.

We heard from the Minister about the new emphasis on recovery-based programmes, and I am all in favour of that. There is everything to be said for that, but even its most ardent advocates do not deny that there will always be a need for in-patient beds for some people some of the time. I am concerned that the cuts imposed on in-patient beds may mean that if we are not very careful indeed there will be enough beds available in future only for people who are sectioned. Those people who wish to receive the support and the underpinning – the fall-back position – of an in-patient bed when they are experiencing an acute episode may be unable to secure one.

It has rightly been said that a debate at national level brings out the best in people in the House of Commons. However, the debate at local level does anything but bring out the best, given some of the schemes, plans and measures that have been introduced. In that connection, I pay tribute to the hon. Member for Lewisham East (Heidi Alexander) who, in a measured and thoughtful way, made a speech that has become all too familiar to me. She talked about the way in which Granville Park in her constituency has been scheduled for closure on the basis of a consultation that she regarded as somewhat suspect.

I refer the hon. Lady to the Adjournment debate on the Floor of the House introduced by my hon. Friend the Member for Burton (Andrew Griffiths), who discussed similar techniques that were used in his constituency, and to my own experience with the Southern Health Foundation Trust, which used a similar method to make 35% cuts in in-patient beds for acutely ill adults, even though bed occupancy figures were consistently over 90%. The pattern seems to be something like this: they hold a consultation; they make assertions based on, at best, subjective surveys of what they say people want; they then rely on pseudo-independent “expert” research, which usually turns out not to be independent at all; and finally they bulldoze their pre-existing plans through.

Therefore, to take the message that Mr Speaker always used to give when teaching the art of rhetoric, which is that a speech should have at most two main points, the main point in my speech is the need for the objective monitoring of statistics so that when we are reconfiguring services we at least know whether there really are spare beds before we close services down.

I would like to be fairly positive in this debate, brief as my contribution necessarily is, so I would like to say that the Health Overview and Scrutiny Committee of Hampshire County Council, despite the harsh words I have had to use about it in the past, appears to be taking on board some of my concerns by seeking to ensure, as it has stated in its minutes,

“that further bed reductions are being safely managed”

and that it is

“made aware by the commissioner and provider should future acute inpatient bed demand regularly exceed bed availability in the service.”

I think that it is terribly important that in the process of reconfiguring we do not simply say that we are recreating a new system in the community while decimating the system that allows people the safety net of an acute bed during those episodes when they are really ill. As I said in my brief intervention on the Minister, if people are to have the confidence to get on with their lives and know that they can have useful and fulfilling careers even while living with and managing a mental illness, it is absolutely vital that they also know that, on the rare occasions when they really need the ultimate support of a few nights or even a week or two in an acute unit, a bed will always be available for them.