My Lords, I speak to my Amendment 38 and declare my health interests in the register, particularly as a trustee of the Centre for Mental Health and an honorary fellow of the Royal College of Speech and Language Therapists.
This amendment is short and simple. As its explanatory statement makes clear, it merely adds to the list of requirements for membership of an integrated care board that must be included in the ICB constitution. I believe it is essential to have a representative of mental health trusts for each ICB area, and therefore on the ICB, as it is the key strategic body for, among other things, healthcare commissioning, planning priorities and resource allocation for a local area.
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The broad context of my amendment is to ensure that what progress has been made—and there has been progress—regarding the concept of parity of esteem between mental and physical health, and crucially the allocation of resources to mental health, is not lost in the new structure of the integrated care boards.
We have already had some powerful and compelling debate around the concept of parity of esteem, which I will not repeat today, but suffice it to say that, through this Bill, we must not lose the fact that Section 1 of the Health and Social Care Act 2012 enshrined in law equivalent duties on the Secretary of State for Health in relation to the improvement of physical and mental health services, and that, since 2013, the NHS Constitution for England has contained a commitment
“to improve, prevent, diagnose and treat both physical and mental health problems with equal regard.”
Obviously, this overall context is much broader than my amendment, but it has and will form the backdrop to many of our debates in the coming weeks. However, as a crucial step, and to secure that the commitments to mental health services are honoured, we must ensure the most appropriate and relevant membership of integrated—I stress “integrated”—care boards.
That is why I also support other amendments in this group, particularly Amendment 37 in the names of my noble friend Lady Thornton and others, in which proposed new paragraph (d) mirrors my amendment but also includes, as we have heard, directors of public health and social care providers. They must be included. Amendment 39 proposes an expert in learning disabilities and autism, which I strongly support. I look forward to hearing the noble Baroness, Lady Hollins, who I have tremendous respect for, speak to that amendment. It also must be accepted. Further, I have added my name to Amendment 40 in the name of the noble Baroness, Lady Finlay, to include allied health professionals. I give a particular mention to speech and language therapists. Along with other allied health
professionals, they will continue to play an important role, as the Government have recognised, in delivering the NHS long-term plan.
All these bodies are critical parts of delivering along the various pathways for mental health services, from early intervention and prevention to the most specialised care, and include the interface with the criminal justice system, such as liaison and diversion services. Therefore, it is essential that each of these bodies, and others, has a seat at the board table, and that, specifically, mental health trusts are statutorily included, as my amendment proposes.
If we take my own home area, Greater Manchester, as an example, there are essentially three mental health provider trusts covering the ICB area. I am sure they could agree who should serve on the board and ensure that the interests of mental health services are heard loud and clear. Without their voice, there is a real danger that the very powerful interests of acute trusts, principally delivering physical health services, will dominate the agenda, possibly undermining commitments on parity of esteem and skewing decisions on resource allocations —both revenue and capital—away from investment in local mental health services.
The Minister may suggest that such prescription is not required or that guidance will be sufficient to persuade ICBs to including mental health trusts on their boards. I have no doubt that the chair-designate in Greater Manchester, Sir Richard Leese, fully understands the imperative to include them on the board, but this is not good enough. This requirement must be underpinned by statute, otherwise there could be a lack of consistency across the 42 ICB areas that undermines equality of access to mental health services and further limits transparency and accountability to local people for decisions that will be taken on their behalf in respect of their mental health and well-being.
I feel sure that the Government will recognise this, and I look forward to a positive response not only to my Amendment 38 but to other amendments in this group that aim to protect the interests of mental health services across the country.