Eating Disorders Awareness Week

I beg to move,

That this House has considered Eating Disorders Awareness week.

It is a pleasure to serve under your chairmanship, Mr Bailey, for this very important debate. As we are in the middle of Eating Disorders Awareness Week, this is a timely day on which to remind ourselves of the good work that has been achieved in the past year, but also to look forward to where we want to be by this time next year.

I want to take this opportunity to thank Beat—the Eating Disorders Association—and the many other charities that have been in touch with me ahead of the debate for their sheer hard work and determination to keep this issue at the forefront of the Government agenda. I see many of you in the Public Gallery and want to say thank you for all that you do.

There is always great cross-party support in debates on eating disorders. I have been in this place for only 18 months, but it is the debates in which we are all travelling in the same direction that are so powerful, because we show our constituents that we can agree, and when we do, this place is much stronger and improves lives much more quickly.

As we know, eating disorders affect more than 1.25 million people throughout the United Kingdom, but that is a conservative figure, because many sufferers have not yet been diagnosed or identified. It is for that reason that this debate is opportune. We are all here today for those in the Gallery, for those who are fighting for this cause, for those who are currently fighting this debilitating disease, for those who have fought and come through it and for those who are currently living their daily lives as normal but may suffer at some point in the future. My colleagues and I will always fight your corner, and I am delighted to see many hon. Members here today to support the debate.

I wish to begin with the topic of stigma, which is the focus of the Eating Disorders Awareness Week campaign this year. As we know, eating disorders affect all age groups, genders and backgrounds. An eating disorder is not a diet gone wrong, a fad or a phase. It is not caused simply by a young female being exposed frequently to magazine images of skinny models or going on online platforms with similar material and deciding that they wish to look the same. It is an illness so deep rooted in the individual that it leads to devastating consequences for those who are suffering and for those around them.

My hon. Friend has talked about the effect on constituents. I have to say that, in this case, it was the effect on me, because a close member of my family suffered from an eating disorder. The help that was available was pretty close to negligible. Does my hon. Friend think that there is much more that we can do to increase the help available for people whose family members are in that sort of situation?

My hon. Friend is absolutely right. The sufferer of course needs specialist support, but I will go on to speak about how I believe that we also desperately need to support families and, indeed, all those around them. This disease is so complex that it is often difficult to treat and, trapped in the disease, sufferers feel that there is simply no way out. Many believe that if the disease does not take them, they will take their own life, just to rid themselves of it. No matter how strong an individual is, an eating disorder is so all-consuming that once it has taken hold, some people believe that they will never live a normal life again, and many do not: the condition becomes chronic for about 20% of sufferers.

Normally, a series of events has encouraged the person’s mind to think differently about their body image. Perhaps they have decided that they are not good enough: one too many times, people or life events have created a narrative in their mind that they are inferior to those around them, or perhaps life is out of control in many aspects—nothing is going right. They compare themselves with others around them and see only the negatives in their own life and the positives in other lives, but they can take back control of one aspect of their life—control of what they eat. That may well start off as a diet, but not a diet that would be followed by a normal individual, which often fails. It soon becomes a focus and then a more extreme calorie-counting exercise that involves hiding food, burning off every calorie possible and social isolationism. Before they know it, the candle is burning at both ends. Before a sufferer has identified that they need help, the registered impact on their body is always perceived as being caused by some other reason. There is a voice inside a sufferer screaming that too much food is being consumed or not enough exercise is being done—praise when they miss a meal or hear the sound of a rumbling stomach. That voice inside a sufferer will not and cannot go away.

I call Louise Haigh.

The hon. Lady is making an excellent speech. I am troubled by the fact that, a year on, services in York are still completely inadequate. On Friday, I spoke to GPs who are trying to manage individuals with eating disorders. They have been instructed to take patients’ blood, to monitor the electrolytes, and to weigh them frequently, without the psychological support and clinical competencies that are necessary. Is it not absolutely essential that GPs receive the training that they need, so that we can put in place the holistic services that patients need?

The hon. Lady is absolutely correct. I will come on to speak about that in detail. I hope the Minister will give further detail on how she is approaching that with other Departments.

In any five-year medical degree at UK medical schools the average amount of training in eating disorders was 1.8 hours, and one in five gave no training at all. The concern is not confined to one part of the United Kingdom; it is a widespread issue across all nations. That seems absolutely extraordinary, given that this is one of the most fatal mental health disorders, affecting 1.25 million people. GPs must be able to tell the difference between a healthy exercise routine and a compulsive one, low body-mass index and lack of nutrition, and going through a diet phase and the beginning of an eating disorder. They must recognise the clear indicators and how eating disorders manifest in order to deliver the right treatment plan, but to do that they need training.

I would like to see further encouragement of self-referrals and more work with schools, where many members of staff may be able to identify unusual behaviour. I warmly welcome the approach taken by my secondary school, Brechin High School, which has appointed a member of staff to lead on mental health who has a support base within the school and is linked up with the local primary schools, so that at the end of primary school, when an eating disorder—or any mental health disorder—may begin to develop, that support is monitored and continued as pupils enter secondary school and progress their education. I am keen to hear from the Minister how the training aspect can be addressed. I would like to hear from the Scottish National party spokesperson how the Scottish Government could do more to include training within university tuition, and how they will address the role that schools can play in early intervention.

When help is needed, how long do we have to wait? Waiting time targets have been a focal part of the campaigns run by many charities for years. In England and Wales, by 2021, 95% of eating disorder referrals for those under-19 are due to reach a specialist within four weeks, and within one week for urgent cases. Will the Minister confirm that the Government are on track to deliver that target, which is already making a huge impact? Along with the charities, I warmly welcome the ambition shown by this Government.

Before I move on to the other speakers, I point out for the record that the intervention was made by Rachael Maskell, not Louise Haigh, her close friend. However, I noticed that she did not notice; confusion reigns. I call Paul Farrelly.

Thank you, Mr Bailey. I congratulate the hon. Member for Angus (Kirstene Hair) on her success in securing this debate during Eating Disorders Awareness Week. I thank Beat, the eating disorders campaign group, for its unstinting efforts on behalf of the more than 1 million sufferers across the UK. After this debate, from 11 o’clock to 3 pm, during the lobby of Parliament, I am hosting a drop-in event with my good friend, the hon. Member for Stafford (Jeremy Lefroy), in room R of Portcullis House; colleagues here and those listening can go there to find out more about Beat’s work.

This debate follows that secured last October by the hon. Member for Bath (Wera Hobhouse), which shows that support for this cause is truly cross-party. We also had a debate on the subject in September with the children’s Minister, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), highlighting the issues for vulnerable children going into adulthood. In that debate, I focused on concerns that regularly pop up in my area of north Staffordshire for young adults suffering from anorexia, bulimia and other eating disorders, which have such devastating effects on them and their families.

The impact on young adults is one example of a core concern of the Parliamentary and Health Service Ombudsman’s groundbreaking 2017 report, which I will focus on again today. This suffering and vulnerability does not stop when children reach the age of 18. However, in my immediate locality—Newcastle-under-Lyme, Stoke-on-Trent and Staffordshire Moorlands, which have a population of well over 600,000 people—the commissioning of specialist support and treatment does stop at the age of 18.

Staffordshire is served by six clinical commissioning groups, with one common accountable officer. The budget for specialist, post-18 eating disorder services in the four CCGs serving the centre, east and south of the county is £428,000 a year, but for the North Staffordshire and Stoke-on-Trent CCGs, it is exactly zero. Sufferers who, up to the age of 18, had been used to specialist support in the community or at in-patient facilities have to rely thereafter on the hard-pressed, overstretched and generalist child and adult mental health teams. It is a postcode lottery—an “unwarranted variation”, in the NHS jargon—that has persisted for far too long, is patently unfair and lets local families down badly.

Before I call John Lamont, I inform hon. Members that I intend to start calling the Front-Bench spokespeople by 10.30 am at the latest. After some simple arithmetic, that works out as about five minutes per speaker, if we are to get everybody in, as I intend to. I will not impose a hard time limit now, but each speaker should bear that in mind.

It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate my hon. Friend the Member for Angus (Kirstene Hair) on securing this important debate during Eating Disorders Awareness Week. She made a passionate, well-informed and thoughtful speech, which I learned much from.

In my area of the Scottish Borders, some great charities and organisations work with young people to overcome issues such as eating disorders. There are now counsellors in every high school in the Scottish Borders, so teenagers have someone to speak to at school who is not a parent or teacher. We also have a specialist eating disorder nurse based in the Scottish Borders and some great work is done in the child and adolescent mental health service to support younger people.

I am sure that there are many good examples around the country. My hon. Friend the Member for Cheltenham (Alex Chalk) has spoken to me about the Brownhill eating disorder clinic in his constituency. He holds the clinicians and the work they do for his constituents in high regard.

Treatment across Scotland is patchy to say the least. In the Scottish Borders, there are no community tier 1 services aimed at preventing the onset of eating disorders locally and waiting times for help are far too high, as we have heard. I will focus on the impact that technology can have on the issue. The all-party parliamentary group on technology addiction looks at how smartphones, tablets and social media can have a detrimental impact on our health.

We have all seen the shocking stories about how diet pills, some of which contain lethal substances, are readily available to buy on social media, or how eating disorder-related hashtags and accounts are available and easily accessible to vulnerable people. Some of the content is more subtle. Platforms where we show only the best of ourselves mean that young people in particular can find it harder to feel content with their lives. Online images of thin and happy people clearly act as a trigger for some.

I thank my hon. Friend for giving way and for making an excellent speech. Does he agree that this process should be about more than warnings and that there should be a proactive attempt to stop this sort of material being visible in the first place, which needs to be algorithmic and technology-based, so that people can recover in the community?

I absolutely agree with that important point and the social media platforms that are responsible for their content need to understand it much more clearly. They cannot just allow a free market, as it were, on their space, and if people are putting content on it that is clearly leading people to harm themselves, action needs to be taken, either by the companies themselves or, if they fail to do so, by the Government.

Perhaps above all, a vast array of online communities has been set up by people who have been through this experience and want to offer support. The internet can provide something that is immensely powerful—the sense that someone is not alone if they suffer from an eating disorder. That is what makes this issue so complicated. When it comes to eating disorders, the internet is both an enabler and potentially a powerful tool for good.

We will never get to a situation where eating disorder triggers can be removed entirely from social media. So, instead let us use technology as part of the solution, as best we can.

It is a pleasure to serve under your chairmanship, Mr Bailey. I, too, pay tribute to the hon. Member for Angus (Kirstene Hair), who secured this debate and made an excellent speech, and to the other colleagues who have contributed to it so far.

Without doubt, eating disorders have acquired a greater profile in recent years, and there are two things that are apparent and that we can learn from. One is that, as a society, we are better at talking about these things, and organisations such as Beat, which has already been mentioned, do outstanding work in making people feel that the stigma around these issues is something that we, as a society, need to get over, and therefore people will feel more comfortable about coming forward, which is good.

The second lesson that we might learn is that we are a society that, for some of the reasons that have already been mentioned, increasingly breeds poor mental health. So, I will focus my remarks on the support—or lack of it—for young people living with mental health conditions and particularly for those with eating disorders in my constituency of Westmorland and Lonsdale.

Very often, it is the parents who come to me first. Parents come to me with two clear emotions: one is terror; and the other is guilt. It is absolutely essential that we are clear to people with eating disorders, and indeed to those who love and support them, that there is absolutely no need for guilt; there is no blame attached whatever. Likewise, we need to tackle the fear and the terror, which often stem from a lack of understanding or an absence of hope as to where to go next, by showing that there are things that we can do to help.

In my constituency, we estimate that three quarters of young people with eating disorders were not seen within the target time of one month, and that 100% of those with an urgent need were not seen within the target time of two weeks. That is not acceptable, but what is even more terrifying is that the numbers involved are ludicrous. In the year up to August 2018, a grand total of 13 young people in South Lakeland were registered as living with eating disorders, which is baloney: we all know that that is not true. I would comfortably say that the real number is 10 times higher. In my office, we deal with at least one new case of an eating disorder every single week. So what is happening, such that our young people with eating disorders are falling through the gaps? We need to look at a whole range of things, but I especially ask the Minister to investigate personally why this is happening, particularly in South Lakeland but—I suspect—around the country as well.