Part of the debate – in the Senedd at 5:13 pm on 5 July 2016.
Diolch, Lywydd. Minister, thank you very much for bringing forward this debate today. I have read the delivery plan with a great deal of interest and I concur with you on the Government’s overriding objectives—what you’re trying to achieve in terms of improving mental health delivery here in Wales. I don’t think anyone would quarrel with your objectives and much of your methodology.
You’ve touched, yourself, on how we are fighting this stigma at present, and that goes through all areas. It’s not just the stigma of one person against another person, but cultures can be inherent within organisations that can stigmatise people who have mental health issues. There’s no doubt that we definitely need more equality of entitlement to treatment between mental health and physical health, and this is one of the areas where I really would urge you to consider further how Welsh Government might be able to bring this forward.
I’m loath to mention the NHS in England, because I know that looking anywhere across the border tends to be a great anathema to many people here. However, within the NHS in England they have put forward a parity of esteem concept and it’s being introduced, in which equal rights for people with physical and mental health difficulties have been adopted, which has gone some way to acknowledging mental health needs, particularly of people with medical conditions. I wonder if it may be useful looking at that, and I’m sure other countries will also have very similar ideas, to see if we may be able to adopt any of those and move them forward in our own health service here.
I’ve got five sort of key areas I’d like to talk about, and I’m absolutely delighted that you are adopting our amendment. I did note what you said—ring-fencing isn’t about this as the maximum but rather the minimum—but sadly a lot of organisations will use at as, ‘Phew, as long as we’ve just spent what we have to, then no more’, and you do see it throughout Wales; you see it in a lot of organisations. They’re all hard-pressed for money; they’ve all got a lot of competing claims on a finite resource, and mental health does quite often come off as a cinderella spend in some of these organisations. So, we believe that an integrated demand and capacity planning model would be a much better way forward. It would also be a very good way of then being able to explore truly the demand, because mental health issues have a great many different shades of grey to them. And if you start to include, for example, young people with learning difficulties, which are very often as a result of some kind of mental health distress, then that also should fit into the bigger brief of mental health. So, delighted that you’ve agreed to accept that amendment, but I would like to be able to bring this debate back to the Chamber in six or eight months to find out how the Government are going to make that work and bring that forward.
I’d like to pick up on performance measures. In order for the strategy to be delivered effectively, we need to have an outcomes-based approach that is supported in parallel by a suite of these new financial indicators. We need to have greater public reporting by LHBs, local partnership boards and public service boards. I’d like to understand, Minister, what your report or your delivery plan doesn’t say, which is that in the many areas where you already have put targets in, how well you’ve achieved against them. So, for example, out-of-area placements for children and young people reduced below 2013-14 baseline by 10 per cent every year, so we need to have some kind of report that comes back out so we can measure where we are. And when we’re talking about how we do reporting, let me just pick another one, which is one where you virtually say it was just slightly woollier, where it’s saying that one of the measures of outcome would be to have feedback. How do you define ‘feedback’? Who collects it, who measures it, and who actually gets to see it? Is it going to stay within the organisations? Will it be sent forward to Welsh Government? There are so many indicators that have been nominated here; an awful lot of them don’t have hard cases attached to them in terms of where they get reported, who sees that reporting and who can take action. So, I’d urge you, Minister, to pick up on those.
I’m sorry; I’m galloping through this, because five minutes isn’t a lot to talk about such an important subject. CAMHS in-patients and waiting times; I think perhaps I will just say on this issue that I can see that the Chair of the new Children, Young People and Education Committee is present, and I’m absolutely sure that she will look forward to examining what is happening with CAMHS waiting times for young people and children, because although your report talks of it very successfully, we know that the Shillabeer review is not delivering everything that it should do, and we need to pick that up more.
And finally, Presiding Officer, I suspect I’ve run out of time completely to wind up, but I just wanted to say to you that the whole area of mental health delivery is so very important. If we just look at our young people, 23 per cent of all young people who attend at schools in Wales have some form of mental health impediment. It stops them from learning, it stops them from being successful, it stops them from having the lives that they should have, and when you start from that very level all the way through to people with autism, people with Asperger’s, people with syndromes that are recognised and have pathways, we have to help them because that is such a great percentage of our population who are not being the citizens they could be, and not having the help that they could be. So, anything that you want to do to improve mental health services in Wales, I’m absolutely prepared, and this party is prepared, to try and support you, but we do want credible outcomes, credible performance measures, and credible reporting back to the Assembly. Thank you.