Catherine West

It is a real privilege to be awarded an Adjournment debate to discuss the profile of social care in decompressing the strain on mental health services in Hornsey and Friern Barnet. I begin the debate by emphasising how many improvements we have seen in society over the past 20 years when it comes to the position of people who suffer from poor mental health. I do not want this debate to be a counsel of despair. Rather, I want it to be an opportunity to push forward the work that Baroness Casey from the other House is doing, and to be positive about what can be achieved with the opportunity we have—with people seeing mental health services as part of a normal health condition—and how we can support people to have long and happy lives and live with a condition, and to support families and so on. I know that Members across the House will have constituents who get in contact time and again because they have fallen through the cracks of our porous health and care system. Navigating the endlessly complicated care pathways, from primary NHS care to social care, community support and housing, is not easy. The exponential growth in mental health referrals, coupled with the enormous pressures on local authorities to provide social care and social housing against increasingly constrained budgets, has created a perfect storm. That is being felt across the country, but most acutely in my community, where people are too often failed in their time of greatest need. Too many people are being left without the care, support and stability they desperately need to recover. A previous Labour Prime Minister emphasised that his priorities were “education, education, education,” but when it comes to mental health and social care, we need to talk about “early intervention, early intervention, early intervention”. The North London foundation trust, which covers Barnet, Camden, Enfield, Haringey and Islington, says that the financial challenges facing local authorities are really straining their ability to work together, as they are forced to consider more radical reductions in adult social care services. In particular, the reduction in investment in preventive and early intervention services is having a catastrophic effect, but local trusts are finding it hard enough to fund their basic statutory responsibilities. The lack of suitable housing and step-down care is also having a direct impact on in-patient services and contributing to much longer hospital stays. That is the system I will be focusing on today. The trust says that of the five local authorities it covers, Haringey is the most affected by the lack of suitable and affordable housing, and therefore has the largest number of delayed discharges. From January to July 2026, a total of 846 occupied bed days were unavailable to other patients desperate for care due to Haringey residents being unable to be discharged from mental health in-patient wards despite being clinically ready for discharge. In July alone, the trust had an average of 10 in-patients on their wards who were clinically ready to leave but could not be discharged due to lack of suitable housing provision or social care support, and 8% to 12% of the total adult in-patient bed base was unavailable to other patients who needed one. Healthwatch Haringey has highlighted the recurring barriers to gaining access to timely, co-ordinated and person-centred mental health support, such as lack of continuity between services, fragmented care pathways and inconsistent communication between providers. When services do not work together effectively, people experience poorer outcomes and are more likely to reach crisis point. This is precisely the cycle that we need to break. We need to protect organisations like Healthwatch and others that amplify voices so that we can understand the data behind monitoring service quality and amplifying patients’ voices. Someone who is clinically well enough to leave hospital can become trapped at the most expensive stage of the care pathway, unable to continue their recovery in the community. At the same time, someone desperate, experiencing an acute mental health crisis, may be unable to gain access to a hospital bed. This is not an effective use of public money; that public money could be spent on quality of care, which is desperately important for the families who are suffering due to issues around the particular care that their loved-ones have received. In March 2024, mental health trusts in England recorded 49,677 delayed discharge days—the highest level since national reporting began. Analysis of NHS data identified Barnet, Enfield and Haringey mental health NHS trust among the trusts with the highest levels of delayed discharge nationally. These figures demonstrate exactly the point I am making today: mental health cannot be treated in isolation from housing and social care. In order to fix one, we must fix all three. Disability Action Haringey, which does excellent work supporting disabled people to maintain their independence and freedom, has highlighted the combination of difficulties in accessing suitable housing, delays in obtaining social care, the financial hardship that so many suffer, social isolation and the challenges of navigating multiple services simultaneously. People experience poor housing or insufficient care, their mental health deteriorates, and they reach crisis point, requiring hospital treatment. We must break that cycle. In my constituency, the Safe Haven crisis hub provides a vital service, helping people to de-escalate during a mental health crisis and providing an alternative to accident and emergency. I know that this is the kind of example that Baroness Casey will be looking at. She is very welcome to come and visit Mind in Haringey, which hosts this particular crisis hub, because it shows the best practice. Staff there have seen people reaching out to their services with increasingly complex needs, often requiring co-ordinated support across health, housing, social care and the voluntary and community sector. That is why collaborative care and cross-body communication are so critical. We also have a rapidly ageing population across Haringey and Barnet, which will inevitably place additional pressure on social care. Haringey council’s older people’s needs assessment reported that Haringey had around 27,700 residents aged 65 and over in 2022, and that figure is projected to rise by approximately 40%. The pressure on our social care system is therefore going to grow, as we all know, and we need to ensure that the system is ready for it. The evidence is clear: mental health services cannot be considered in isolation from social care. Investment in social care is not separate from investment in mental health services—it is investment in mental health. Investment in supported housing is not separate from relieving pressure on the NHS, but part of relieving that pressure. Investment in community-based support is not simply about providing an alternative hospital, but about helping people to recover, maintain their independence and avoid reaching crisis point in the first place. I strongly welcome the Government’s commitment to address these enormous challenges, and was particularly excited to hear the Prime Minister talking about tackling social care in advance of 2028, which was when Baroness Casey was going to report back. I also welcome the Government’s wider action to improve mental health care through the NHS 10-year plan, and would like to ask for a meeting to discuss standards of care in the mental health service. I also invite Baroness Casey or the Minister to Mind in Haringey to see an excellent way in which the statutory and voluntary sectors work together. The Government’s actions meant that, earlier this year, we successfully reached the target of recruiting 8,500 mental health workers. That is a crucial step towards providing better and earlier care, closer to people’s homes. I welcome the £343 million to open 159 NHS mental health centres across England, which will give people access to specialist support away from A&E. These problems are not just about cash, but about the system being proactive and improving workforce morale so that we can improve outcomes for patients. Investment in housing is crucial, but the £39 billion earmarked for social and affordable housing has the potential to be transformative. Yesterday, we heard the Secretary of State for Housing, Communities and Local Government lay out her vision for tackling rough sleeping, which is an element in the mental health jigsaw puzzle. If we want people to maintain their independence, they need appropriate homes and community support. If we want to prevent people from reaching crisis point, we need to address the circumstances that contribute to stress, worry and deteriorating mental health. Social care reform has been pushed down the road too many times, but now is the moment for it to come forward. We must invest further upstream to improve people’s lives, free up NHS capacity, reduce unnecessary hospital stays, support recovery and create a health and care system that is preventive rather than reactive. People living in Hornsey and Friern Barnet and communities across the country should be able to live safely, recover with dignity and get the right support. In pulling together my words, I thank the wonderful mental health staff at the North London NHS foundation trust, which sadly lost members during covid, because they were so close to patients—I feel that it has still perhaps not got back to where it was pre-covid. We need to support that workforce. I also thank Mind in Haringey, Safe Haven, Disability Action Haringey, Healthwatch Haringey, Haringey council, Barnet council and all the elected Members who care deeply about the future of social care in the UK.