My Lords, I support this group of amendments, particularly Amendments 8 and 12.
We had a good run over the issue of the equivalence between physical and mental health in the Health and Social Care Act. We need to move on from this rather semantic debate about whether healthcare involves both physical and mental health. Out there in the real world, there is a real sense and feeling that mental health does not receive its fair share of the attention that it needs. The political and public agenda in this area is beginning to change, which is a good thing, but we should not lose any opportunity, when legislation presents itself, to reinforce the message about equivalence, even if it occasionally upsets the draftsmen and officials of legislation. We cannot use opportunities too often to get across the message about equivalence.
One of my jobs as a Minister in Richmond House was, at one point, to try to reduce the amount of money and effort that was being spent in the NHS on the use of agency staff. It came as a considerable surprise to me, although it should not have done, that when I started to look into this area, particularly in the area of medical locums, psychiatry was represented as one of the specialities where there was a high use of locums because people simply could not get or make permanent appointments. We need to send a message to HEE that there is a longstanding, deep-rooted problem in this area. At the end of the day, if we do not train enough people to fill the established jobs available and we have to rely on locums and agency staff to do so, we will not achieve equivalence.
When the Minister goes back to Richmond House, I ask him to look at some of the data around whether the vacancy rates and the use of locums in psychiatry and psychiatric services is greater than those in other areas. He may find that there are some real issues around that which need to be tackled by HEE.
On Amendment 12, I wish to speak briefly as a former jobbing public sector manager in this area. When times are hard you do two things very quickly: you freeze vacancies and cut in-service training. That is what you do as a jobbing public sector manager. We always have to guard against cutting the kind of programmes, such as continuing professional development, that will help us to get out of some of the jams that we are often in. It is important to send messages about continuing professional development in the Bill. I strongly support the proposals in Amendment 12.
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