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Wera Hobhouse: "Every week in my surgery I get somebody who is affected by mental health problems"

7 min read

Fresh from her successful campaign to ban upskirting, the MP for Bath is determined to ensure that people struggling with mental health problems aren’t cut adrift by the state. She speaks to Matt Foster


Soon after Wera Hobhouse became an MP, she was given some words of wisdom from a fellow parliamentarian. “MP stands for Most Persistent,” the Liberal Democrat was told.

It’s advice that’s stuck with her over the past two years, as Hobhouse – representing Bath after snatching the seat from the Conservatives in 2017 – led a successful bid to outlaw the taking of voyeuristic upskirt photos.

We speak to the MP in Parliament’s Portcullis House just weeks after up-skirting became a specific criminal offence in England and Wales, a major victory for Hobhouse and the coalition of campaigners and MPs she worked with.

The bid to ban the intrusive practice was not without its hurdles - most prominent of which was the opposition from Conservative grandee Sir Christopher Chope, which stopped Hobhouse’s Commons bill dead in its tracks and forced embarrassed ministers to step in and instead push the change through on government time. Hobhouse is sanguine as she reflects on the campaign's success: “If things were easy somebody would have done it already,” she chuckles.

Hobhouse is now determined to apply that persistent approach to another issue that she believes is slipping under the radar: inadequate help for people struggling with mental illnesses. "I could probably say every week in my surgery I get somebody who is affected by mental health,” she explains, estimating that around one in every six of her Friday appointments will be with a constituent affected by a mental health condition.

In fact, the problem has become so endemic that Hobhouse reveals her most senior caseworker recently put herself forward for training to help her better understand constituents who are in the grip of mental health crisis.

“Often, some of it is about your own resilience,” Hobhouse admits. “You get hit on a daily basis with problems, with people who are sometimes suicidal, sometimes depressive. We had a case where somebody said, you know, ‘I have got bomb-making equipment in my home and if I don’t have my answer or my tribunal heard within this period of time, then something serious is going to happen.’ And as much as you can possibly take some of these things with a pinch of salt, it’s obviously quite frightening to hear these things.”

She tells The House that while some constituents simply need signposting to the right services, others have already reached out for help and not been given it. That will often prompt a letter from her office to try and tell the authorities that somebody is struggling and needs more support from the state. But that kind of ad hoc intervention is not, Hobhouse points out, the sign of a system working well. “Ultimately, as an MP, I should only be the person who ensures the proper systems are in place through law,” she says. “I shouldn’t go in there and say – ‘hang on, could you just change your mind on this or that decision? It’s wrong’.”

'PEOPLE ARE REALLY DESPERATE'

Hobhouse also fears that many local residents struggling with mental health conditions are not coming forward – either to her or their GPs. And when they do reach out, she is concerned that they may no longer have access to the kinds of services that once helped people get back on their feet. “The most vulnerable people don’t necessarily come to you,” Hobhouse says. “Of course, we advertise that we are there and people do come. But some people are just so confused. They should really come with their support workers – but support workers are difficult to find as well. So we are looking around, finding help for people who are really desperate, to find a support worker to come to them and stabilise them.”

Although Hobhouse was only elected as Bath's MP in 2017, she agrees with her parliamentary colleagues who fear that cuts to other public services have made the impact of mental health problems “a lot worse” for many residents, and in some cases triggered a spiral. “In constituencies like Bath - we’re seeing instances of people who are really desperate about housing, about Universal Credit, about Personal Independence Payments," she says, reeling off the names of two major welfare reforms. "These numbers have increased dramatically. People might be perfectly well and have had the right support over years – but they’re plunged into mental health problems by severe financial difficulties or [a lack of] housing support.”

In the NHS too, Hobhouse believes the system is creaking. Ministers have long talked about achieving ‘parity of esteem’ between mental and physical health. But Hobhouse is sceptical that last year’s £2bn real-terms cash boost for mental health service is yet translating into practical action on the ground.

The NHS as a whole remains, in her view, “severely underfunded”, with the headline figures masking the fact that trusts are having to simply “plug some holes” after years of squeezed resources. “And the problem is always the oversight of where this money’s actually going,” she adds. “Are individual trusts spending the money in the way they should be spending it? And since the whole NHS is very fragmented now … it’s a lot more difficult.”

Hobhouse is particularly determined to draw attention to the plight of those suffering from eating disorders, and she is currently running a cross-party ‘Dump The Scales’ campaign alongside mental health campaigner Hope Virgo to ensure that those who are struggling do not continue to fall through the cracks simply because they’re deemed not to be “thin enough”.

NHS doctors are currently expected to follow guidelines drawn up by the National Institute for Health and Care Excellence which make clear that they should not use weight as the sole criteria for deciding whether somebody gets help or not. And yet, Hobhouse says, scales continue to be the first thing that many health professionals reach for when diagnosing an eating disorder. “Once somebody severely underweight presents in a GP surgery then a doctor takes notice,” she says. “But actually the problem is when people don’t recognise an eating disorder because somebody actually has a healthy weight.”

Such an approach, Hobhouse says, risks missing a vast swathe of hugely damaging eating disorders that do not make themselves immediately obvious through the blunt instrument of a Body Mass Index (BMI) check. “You have to dig a little bit deeper to understand what the person’s actually suffering from," she adds. "And the worst thing you can do with somebody who’s got an eating disorder is when the doctor puts the person on the scale and says ‘oh, actually your BMI’s fine so you’re fine’. A lot of victims of eating disorders and sufferers of eating disorders tell us that that is just a massive setback.”

Despite the huge damage that an eating disorders can inflict on sufferer, Hobhouse worries that too many politicians still see the problem – and mental illness more broadly – as a “softer" issue somehow less deserving of attention than the great matters of  state. “It’s a crisis," she warns. People are dying. The highest death toll that we have from eating disorders is because people either commit suicide or starve themselves to death. So it’s a real, real crisis. And yet, it doesn’t seem to be taken seriously enough, possibly because for too long because it was seen as a sort of middle class, white girl’s problem. It isn’t. It transcends any class, any age, any gender - it’s widespread among the population as a whole.”

Hobhouse recently handed in a 70,000-strong petition to Downing Street, urging ministers and NHS bosses to do more to enforce the existing guidance on eating disorders and improve training for junior doctors. Like the push to ban upskirting, the MP says she draws strength from working with campaigners from outside Westminster – as well as across party lines – to get things done.

On the broader mental health front, Hobhouse is determined to keep pressing ministers to “follow where the funding is going” and ensure that headline-grabbing NHS cash injections are turned into something tangible for those people who look set to keep walking through her constituency office door looking for help. “How much that has filtered through to government decision-makers, I don’t know,” she says. “But the other day I heard some Labour MPs in a Westminster Hall debate. They said: ‘The government always says no before it says yes.’”

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