Tag Archives: Conservatives

Lies, Damned Lies & Tory Jeremy Hunt’s Mental Health NHS Statistics

Lies, Damned Lies & Mental Health Statistics

This month saw World Mental Health Day. For the other 364 days of the year, we are forgotten. Austerity Britain has affected mental health services more than most. Despite promises to ringfence the NHS and bring parity between physical and mental health, this has not happened. Instead, beds have been cut, jobs have not kept pace with population growth, and my own trust, NSFT, has been placed back into special measures again, after being the first mental health trust in the country to be sanctioned in this way by the Care Quality Commission (CQC) in February 2015.

Mental health awareness and NHS service provision improvements are sorely needed as referrals have risen 20% in Norfolk and Suffolk, but staffing and beds have been cut. Complaints, locally, have risen from 430 to 592, 2013-16. The latest CQC report criticised inadequate staff and bed levels but praised staff the caring attitudes of staff as ‘good’.

The recent Stevenson/Farmer ‘Thriving at Work’ report has demonstrated the need to promote mental health at work due to its annual near £99bn cost to the UK economy.

  • 2010-20 will be the most austere decade in NHS history
  • 2010-17 UK population rose 5%, mental health staff up 0.87%
  • 2011-14 33% rise in Police cases with mental health component
  • 2010-13 56% rise in self-harm and suicide
  • Mental health at work costs UK economy up to £99bn
  • Entitlement to be seen <18 weeks applies to mental health too

A week ago, BBC Radio Norfolk ran a mental health week focus with Stephen Bumfrey featuring it each afternoon, and coming together with Nick Conrad, Sue Tebble and myself, on Friday 20th, for an hour-long special. (iPlayer episode – 2hr 32m in

On Radio Norfolk’s Matthew Gudgin programme, the BBC’s Bob Carter challenged Theresa May to apologise to the people of Norfolk and Suffolk for having the worst mental health trust in England. Listen to the interview below:

Theresa May

During a recent visit to Archant, home of the EDP, in Norwich, the Prime Minister said:

“overall if you look across the country there is a good record of actually being able to move trusts out of special measures” – Theresa May

This makes the failure to resolve the local NSFT crisis all the poorer. Patients, or the politically correct – ‘service users’, have complimented the staff but criticised the system, waits, and other failures. Patient deaths and out of hospital suicides have increased whilst beds and budgets have been cut. Hundreds of patients were sent out of county owing to the lack of beds, up to 225 miles away!

In 2012/13 the trust reported 53 unexpected deaths, 105 in 2013/14 and 14/15, 139 deaths, rising again in 15/16 to 158, and 140 in just 9 months of 16/17. When standardised for age it is above the average for England. The figures have risen across all regions during NHS austerity under this government, from 47 per 1,000 to 59 in England – up 25%, but from 44 to 66, a rise of 50% in Norfolk & Suffolk.

Jeremy Hunt

Jeremy Hunt, the Health Secretary, has boasted that provision for mental health has “got better” and that he has increased staffing by 30,000 posts. The reality of the lie, and statistics do indeed damn him, is that 4,100 mental health nurses, 4,596 mental health trust beds, have been cut, and just 692 extra staff employed  – an increase of just 0.87% over seven years, despite population growth of 5% during that time – so, in other words, a cut!

“Although NHS funding is rising in real terms, current plans mean that 2009/10 to 2020/21 will be the most austere decade in NHS history. Total spending on the NHS in England increased by an average of 1.2% a year under the 2010-15 coalition government (0.9% for the UK), and is set to increase at the same rate under the current Conservative government. Between 2009/10 and 2015/16, spending increased from £109.1bn to £119.0bn and is planned to rise to £123.2bn in 2020/21. This growth rate of around 1% is below the historical average for the UK of 3.7% per year.”The Health Foundation

In Norfolk and Suffolk, primary care mental health referrals rose 20% between 2013-16, nearly 7 times faster than the population increase.

Wider Societal Impact

Norfolk has a pioneering mental health within Police HQ service, but nationally, there has been a 33% increase in cases with a mental health component 2011-14. As much as 40% of Police time is spent dealing with mental health-related issues.

Eighteen Weeks, as if!

Under the NHS constitutional pledge, patients have a right to be treated within 18 weeks of referral, including mental health.

“the new waiting time standards will be as follows: 75% of people referred for talking therapies for treatment of common mental health problems like depression and anxiety will start their treatment within 6 weeks and 95% will start within 18 weeks.” Pledge of 2014 to be delivered by April 2016.

Yet, the wait for some treatments can be more like 18 months. Just try requesting something more complex than CBT or other less time-limited ‘quick-fix’ therapies. IAPT referrals seen within 6 weeks were apparently 93-96% in Norfolk and Suffolk.

My personal experience, and that of several friends, has been of much longer waits. Calling the acute care line at weekends can result in complete ignorance or lack of access to your medical records. Support lines have historically been cut. People fall between the cracks, and I know too many people no longer with us due to mental health funding and systemic failures.

Discovery or Recovery

Discharge centred mental health, is solution based, with as much an an economic imperative as a wellbeing focus.

“securing a minimum of 50 per cent recovery rate from treatment” NHS

Mental health in Norfolk has a Recovery College, a course-based approach to improving wellbeing. I prefer to see it as a discovery-centric way of improving self-management with community support. Some mental health issues do not just resolve, yet the NHS insists on “developing a recovery culture” (p13) in mental health which fails those with long term or lifetime conditions.

74% of NSFT patients represented with mental illness symptoms within 6 months, compared to a national figure of 63% (2015 data).

IAPT (Improving Access to Psychological Therapies) approaches such as CBT serve best those with mild to moderate conditions, whereas moderate to severe need additional and more specialised help, as e.g., with OCD.

Suicide Risk

Between 2010-13, there was a 56% rise in self-harm and suicide across 52 NHS mental health trusts. It has been suggested that the over-capacity of up to 138% and staffing cuts has increased the risk of incidents.

I find the language, even if it has a clinical meaning, and the reality of response to people at risk of suicide, horrifying. The provision of “low level psychiatric support” was referenced in a Norfolk and Suffolk response it its higher than average suicide rate:

“There is a gap between the Wellbeing Service, the counsellors employed by GP practices and what is on offer via the mainstream mental health services. Suicide rate in Norfolk & Suffolk is high. GP referrals to MH are only accepted 20% of the time. GPs are left to manage risk the rest of the time.”NSFT, pp11-12

The apparent aim is a “reduction in referrals to mainstream mental
health services by offering more low level psychiatric support in primary care.”

Care not Cuts

What worries me, is the low level of funding, of staff, of beds, and the cure rather than care attitude of the system. In contrast, the caring attitude of the staff is to be praised, and they need additional in-work support themselves to be able to deliver services under such tight austerity conditions.

Got the Brexit Blues? Lost your Pink Beret! Reckon Orange is the new Black?

March for Europe, Paint it Blue

Yesterday, around the UK, from London to Edinburgh, Birmingham, Oxford and Cambridge, tens of thousands marched for Europe in an attempt to #paintitblue ahead of parliamentary discussion of the 4-million-plus second referendum petition. Peter Tatchell joined the march and Eddie Izzard, in high heels, gave chase

Orange is the New Black

Meanwhile, Theresa May was away in orange declaring to the US and China that “Brexit means Brexit“, “Free trade means free”, and Britain’s independence would be great – how quick they change their tune, or rather outfits?

Theresa May - "Better off in the European Union"
Theresa May – “Better off in the European Union”?

Political Language turning the air Blue

“Political language… is designed to make lies sound truthful and murder respectable, and to give an appearance of solidity to pure wind.” – George Orwell

In an article in the Economist about how Republicans and Democrats in the US use political language, it was asserted that liberals try to talk facts and policies whilst conservatives are unafraid to aim for the gut.

“…conservatives use language more effectively than liberals in communicating their deepest values” – George Lakoff, The Little Blue Book: The Essential Guide to Thinking and Talking Democratic

The language of politics has also become the toxic language of hate, turning the language of the streets, rallies and even political advertising, blue – not pro-EU, but xenophobia and anti-immigrant fear and racism, both leading up to and since Brexit.

All Black takes on Pink Beret

In other news, europhile Eddie Izzard in hat and heels had his pink beret “headgear stolen near Downing Street by a man dressed in all black with a balaclava covering half his face. Despite wearing high heels, Izzard gave furious chase as police caught the man and tore back his beret while he was pinned to the floor. He then dusted off the pink garment and placed it back on his head before marching to Parliament Square.” – Guardian

Eddie Izzard said: “There was one guy… he went up and snatched my beret – which has a British flag and an EU flag on – and he marched off, he stole it.” The comedian said of the police that they “did fantastic”:

“…there was an inspector, some other officers in there, they took him down. I got my beret back, but it’s gone off as evidence – my beret is now in evidence. I’m out, transgender for 31 years and if anyone steals my pink beret, I’ll get it back.” – BBC

Just to keep things serious, here’s The Pink Berets from the movie Hop (2011):

Political Fashion

Now let’s stop obsessing about what trans people or female politicans wear and get back to what really matters. Oh ok, here’s a quick survey of what female leaders are wearing this season, Eddie – get on trend!

Political Fashion Orange is the new Black
Political Fashion, Orange is the new Black?

Austerity/Labour isn’t working; How to measure a Healthy Economy & Society

Getting Britain back to work? It’s not working!

The language of austerity and recovery (the Tory version or Labour’s “austerity-light”) has all been about working to pay off the deficit, whereas the reality of much of it was about cutting public sector jobs and the benefits of those out of work. The language of Ukip has been about preventing others coming here to work, or labelling migrants as “benefit/health tourists”. According to many international bodies the UK has done well – economically, but socially we are falling apart. Socially and in microeconomics terms, rather than the surface macroeconomic recovery, the Coalition isn’t working, also “Labour Isn’t Working“, the political opposition has been ineffectual.

Measuring the Health of a Nation

Labour Party, The Doctor Can't See You Now General election poster 2015
Labour: The Doctor Can’t See You Now General election poster 2015

In health service resources terms we are 28th out of 30 OECD nations, 19th in terms of our actual health. The health of society should not be measured in mere economic terms. Education, welfare, mental health, attitudes to those that are different, migrants, or asylum seekers, are often a better guide to how we are really doing as a society. When a million people are using foodbanks, something is clearly wrong.

Working Families

Britain isn't eating poster Church Action on Poverty 2013
“Britain isn’t eating” Church Action on Poverty 2013

The language of Labour and Conservatives this election has all been about “hard working families“, with Ukip adding British-only workers to that, but then even Labour wanted to push for British jobs first. On paper, the unemployment rate is almost back to its 5.3% pre-crisis figure along with a massive shift away from public sector towards the private sector. After 5 years of austerity certain types of jobs are growing (self-employment, small business, zero hours contracts – 700k/2.3% of workers), but those without are being left behind – something Cameron promised not to do.

“I want to, if I’m elected, take the whole country with me. I don’t want to leave anyone behind. The test of a good society is you look after the elderly, the frail, the vulnerable, the poorest in our society. And that test is even more important in difficult times, when difficult decisions have to be taken, than it is in better times.” – David Cameron on the Andrew Marr Show, just before the 2010 General Election

Whether disabled, unskilled, mentally ill, being a carer, or struggling with some other difficulty that makes the 9-5 “Arbeit macht frei” ethic not appropriate or possible for all, many are being abandoned, and forgotten. The very purpose of the modern state, the welfare state, even something once quoted but not fulfilled by David Cameron, is to care for the weakest and neediest in society – without scapegoating them as sick scroungers.

Ed Miliband and the #EdStone

Ed Miliband Pledge Promises Stone EdStone
Ed Miliband – Six Pledge/Promises Stone #EdStone

Even Ed Miliband in his Cecil B. DeMille Mosaic stone Tablets announcement this weekend put the economy as the number #1 priority and “higher living standards for working families” as number #2, apeing UKIP and the Tories at number #4 is “Controls on Immigration“.

What no welfare?

Nowhere among Labour’s 6 priorities were people in need, on welfare, even mentioned. For welfare to remain a “dirty” word even with a so-called socialist party shows how times have swung and the extent to which a party will spin and abandon its principles in order to regain power.

Austerity isn't working UK Uncut poster 2012
Austerity isn’t working UK Uncut poster 2012

“Cuts” has been the message of austerity and debt reduction. But those cuts have fallen on the neediest in society, those on disability or welfare, not those most able to pay, or indeed – such as the banks, most responsible for the economic collapse in the first place. In 2012 UK Uncut protested the March budget with a “queue” outside Downing Street and an “Austerity Isn’t Working” poster campaign mimicing the 1978/9 Saatchi poster done for Margaret Thatcher and the Tories.

The verdict of a successful government is not just something measured in economic terms but also in moral and social ones.

Arbeit macht frei

Diefenbach’s 1873 novel “Arbeit macht frei” about a man who “is a gambler and fraudster who, through regular employment, succeeds in regaining the path of virtue” or as another commentator put it “a way for sinful people to be absolved of their transgressions through labor” is the origin of the cruel phrase that was taken on by Nazis and put over the gates of the concentration camps. Diefenbach was a Christian pastor and nationalist and echoed the Victorian work ethic that many so-called reformers in Britain held to in the 19th century.

David Cameron’s Easter message interview with a Christian magazine summed up Christianity as about “hard work and responsibility“, not Christ’s work on the Cross, meaning that, soteriologically, everything was actually already done for mankind.

Jesus said that the “truth would set you free”, the truth seems to be the thing furthest from modern politicians, with all their spin and question-dodging. No wonder 35% of the electorate don’t vote.

Less about Economic Wealth what about Mental Health?

The real hard truth is that “Britain isn’t working”. Inequality is increasing. Our communities are fractured and our countryside fracked. Those not in work are being punitively capped and cut until they can take it no more.

The irony of a government forcing state-funded CBT onto the unemployed yet unable to deliver self-requested CBT via mental health services for those that want to work is clearly lost on the Big Brother worker state. Hundreds of therapists, counsellors, and mental health experts, have written to outline their fears about the emotional and psychological toxicity of austerity and how it is being carried out. Suicides have increased over the last 5 years, especially amongst men.

Big Society or Broken Society?

Is the Big Society broken? Does society even exist or matter? Thatcher’s “there’s no such thing as society” is falsely interpreted though under a Tory-LibDem watch has been almost a self-fulfilling prophecy.

“There is no such thing as society. There is living tapestry of men and women and people and the beauty of that tapestry and the quality of our lives will depend upon how much each of us is prepared to take responsibility for ourselves and each of us prepared to turn round and help by our own efforts those who are unfortunate.” – Margaret Thatcher, 1987

Labour isn't working Conservative's Saatchi poster 1978/79
Labour isn’t working Conservative’s Saatchi poster 1978/79

Saatchi and Saatchi designed the 1978 poster that helped Thatcher win the 1979 election with the tagline “Labour [Still] Isn’t Working“. The Labour Party has spoofed the self same poster nearly 4 decades later. It is time to think outside the box not just rattle and rebrand it.

The truth is society is more broken than 5 years ago even if the economy may be on the mend. Austerity has been toxic. Our health, transport, housing, and education sectors have declined after being starved of resources or sold off to the private sector. Now it is society that needs rebuilding, not the economy. That is the true measure of recovery.

Post-Election Update

Labour isn't working BOB cartoon Daily Telegraph 9 May 2015
Labour isn’t working BOB cartoon Daily Telegraph 9 May 2015

With the Conservatives returned to power, not just coalition but a slim but workable majority, and achieving a rare (once in a century) feat of increasing their vote share, how much did their victory owe to spin and emphasis on the economy not those in need? Are the democratic majority simply selfish? The majority view does not mean it is the right view – ethically, morally, socially. In the meantime the 37 year-old poster image is still doing the rounds with Daily Telegraph cartoonist BOB re-posting “Labour isn’t working” with a queue of unemployed Labour MPs snaking back from the dole office.