So much for Cameron's determination to protect health services for sick children

[Icimoi]

www.telegraph.co.uk/health/nhs/11262751/Police-fury-about-teenage-girl-held-in-custody-because-no-NHS-beds.html

"A senior police officer says a 16-year-old girl with mental health issues is in police custody because no NHS beds are available in the whole of the country.
Assistant chief constable Paul Netherton, from Devon and Cornwall Police, said she was detained on Thursday night and sectioned on Friday lunchtime.
She should have been taken to hospital, but police were told there were no places for her, he said."

"Earlier this month the Commons health select committee warned that children as young 12 were being held in police cells overnight when suffering a mental health episode because of a lack of services for them.
Last year there were 263 occasions in which children were held in cells while an emergency psychiatric assessment was carried out .
Earlier this year a survey of 600 GPs found that one in five had seen a patient come to harm because they could not get specialist help, with almost half saying the situation had worsened in the last year."

But Cameron says:

“For me, this is personal. I’m someone who’s relied on the NHS and … who knows what it’s like when you go to hospital night after night with a sick child in your arms
How dare they say that I would ever put that at risk for other people’s children."

Apparently it's all right with him to put "other people's children" at risk of being in a situation where the only provision for them when they are seriously ill is a police cell.

[Tiredemma]

Its disgusting. A police cell is not the place for someone suffering from an acute mental illness episode especially if they are bloody 16.

[JaneAHersey]

Cameron said before the last general election that he would implement £6 billion of welfare cuts. Which included Health and social care. What we have seen over the past 4 years is a near total decimation of health and social care services as Cameron moves to complete privatisation.

People were happy to vote for Cameron thinking it would be the most vulnerable people who would suffer but just as we saw with Thatcher the greedy net of Conservatism stretches to all who are not the top 1% who we know have seen their wealth grow significantly under Cameron.

[Nerf]

Is the Cameron quote in response to the mental health information?

[CogitoErgoSometimes]

Understand the 'buck stops here' argument but surely this is a question of local management and provision? That the NHS is increasingly not keeping up with the demands of modern living is an organisational rather purely a budget problem. Too simplistic to think this is just a question of 'more money'.

The elephant in the room for mental health services is the problem surrounding the ongoing care of elderly patients, many of whom are being held on psych wards intended for acute cases like the 16yo in the story when it would be more appropriate to provide specialist services in the home or the community.

[Icimoi]

No, the Cameron quote was from his speech at the party conference. I made the connection because on the day he said it I happened to have spent the day trying and failing to access a mental health bed for a seriously ill 13 year old. Knowing exactly how he had put health services for children at risk, that extract from his speech really had me shouting at the radio.

[Nerf]

Oh that's interesting. I do think mental health commissioning is a uniquely shite piece of work (camhs) and seems to have a poor reputation nationally.

[Icimoi]

I'm not sure that this is purely an organisational and local problem rather than a budget one, because it is endemic throughout the country. If it were possible to organise adequate mental health services on the funding available, it would be reasonable to expect that the service would be right, or close to right, in at least some parts of the country; whereas that simply isn't the case. And given that it is a national problem, that makes it a government responsibility.

[WetAugust]

It will be an argument over funding that is stopping the girl from finding a place. The LA will be arguing with her HeakthSuthority over who will pay the bill for either out of area services or private care.

Notice how quickly (and locally) it was all resolved when it became a national disgrace. They went from NO bed in the WHOLE of England to, oh, we've found one just down the road.

Pathetic, with young vulnerable patients as pawns.

In our area the local adolescent psychiatric unit closes to in patients at the weekend.

So beds are available. It's just the agencies in loved that couldn't organise a piss up in a brewery.

[PausingFlatly]

"surely this is a question of local management and provision?"

Heh, why do you think central government is so keen to divest itself even further of responsibility for health and social care provision? So there's always someone further down the line to blame.

Then you can cut central funding and but blame local managers for each individual sadface in the papers.

Same as bedroom tax for disabled. Pass law centrally requiring bedroom tax to be collected from disabled, then tut in Parliament that local councils didn't cough up from discretionary housing fund, when challenged over individuals. Even though you know that discretionary housing fund isn't big enough to cover even 50% of cases.

Shiny Dave already doing this.

It's the X-factor version of medical and care provision: individuals who "win" in the media game get the resources; the rest are left to fate.

[PausingFlatly]

By the way, did anyone notice that sleight of hand with the NHS budget?

You remember that slashing of central funding to local councils? Well local councils provide much of social care, so that got slashed as a result.

Now central govt is telling the NHS it should extend its scope and provide more community care, under guise of "integrating" services. What it actually means is, spend NHS money providing the services cut by councils.

If you can't cut NHS funding directly because of the headlines, cut someone else's funding and tell the NHS to make up the shortfall.

Very clever.

[CogitoErgoSometimes]

Governments are not good at running anything. That's the point. They can set the parameters and provide the finance but - as the disastrous nationalised industries of the past illustrated - running big commercial enterprises is a specialist skill. While the myth persists that all the NHS needs is lots of doctors and unlimited funds, we'll get nowhere.

[PausingFlatly]

Commercial companies are also, sadly, not good at running anything.

Most don't make it out of the starting gate. Those that do can grow moribund as they get larger, and are overtaken; or fall prey to hubris and dodgy practices affecting things internally (Tesco currently) or externally (banks crashing the economy).

They fail and disappear or are bought out, and are forgotten. Woolworths, Railtrack, Arthur Andersen, where are you now?

[PausingFlatly]

It's actually quite hard running big stuff successfully, and maintaining the success for decade after decade.

Every possible format has strengths and weaknesses. There are no silver bullets.

[WetAugust]

It doesn't really matter whether the facility is public ally or privately run if the budget holder on whom they rely for their income will not release funding.

In a serious adolescent psychiatric case you can have 3 parties, social services, the NHS and the education service all attempting to pass the cost of a tong persons care to each other. When they are acting sensibly all 3 parties will usually agree a funding formula between themselves, but until that can take months as they fight to pass the buck between themselves and while they of so the young person's needs go unmet.

Which is why you have 15,year old girls will have been sectioned remaining in Police cells until the national publicity shames the fund ears into action

The heroes in this case are the Police

[PausingFlatly]

Agree, the police have been heroic.

And they themselves are hugely overstretched.

[caroldecker]

The Labour party doubled NHS spending for little benefit. The coalition has increased it above inflation.

[Isitmebut]

Caroldecker …. The NHS money WAS THERE to make a significant difference to our future health needs i.e. significant increases in population, drunks and wrinklies, but under Labour it was squandered as little of it got to the front line, and Public Finance Initiative (debt) spending was to eat into NHS budgets for decades to come.

Governments are generally pants in running their Public Sector, but some are far worse as they use taxpayers money to CREATE jobs/roles, which is why their trade unions and the Labour Party cack those pants at the very thought of ‘competition’ - as this detailed left-on-left assessment (below) confirms – but let me first quote a footnote.

[26] ‘The Institute of Health Care Managers listed 1,700 separate job categories in 1995. By 2002 this had grown to 5,529 : Jenkins, Thatcher and Sons, p. 289. Figure for internal market from Leys, ‘Reducing Social Democracy’s Last Redoubt’.

newleftreview.org/II/62/tony-wood-good-riddance-to-new-labour

“The 2000 NHS Act, meanwhile, called for a ‘mixed economy’ in healthcare, introducing ‘Independent Sector Treatment Centres’ to compete with the public sector in low-risk elective surgery, and expanding the role of private companies in primary care and community health. The same year a Concordat was signed making the use of public funds for operations in private hospitals a normal, rather than exceptional, practice.”

“What has been the impact of these changes? Though NHS funding rose significantly after 2000—on average, 7 per cent a year in real terms—the costs of creating and operating the internal market now consume 10 per cent of the total NHS budget; sizeable sums have gone on the expansion of new managerial layers.” [26]

“The need for public healthcare providers to focus on the bottom line has brought a damaging combination of staff cuts, dilution of the skill mix, and faster through-put of patients; drives to reduce waiting times have meant a rise in the number of readmissions, while cost-cutting in subcontracted services has brought declining standards of hygiene. “

“While PFI has resulted in new facilities being built, their construction has been guided by the rationalities of investment rather than medical assessment of the population’s needs; in some cases they are too small to serve the area for which they were supposedly built. Most damagingly, payments to PFI investors are locked in for a generation or more— a long-term drain on resources out of all proportion to the short-term gains. ”
www.telegraph.co.uk/health/healthnews/9356942/Blair-defends-PFI-as-NHS-trusts-face-bankruptcy.html

“The characteristic paradox of New Labour’s record in healthcare is that, by 2008, there were 13,000 fewer general and acute beds than in 1999, while a ‘burgeoning market of alternative providers’ has developed, ready to draw personnel and resources away from the NHS.”

And Labour’s Mr Burnham, Health Secretary during the last Labour administration, is the man to be trusted now the money is tight and we need a smarter government to do more for less for years to come? P-lease.

[Icimoi]

It's really not relevant what Labour did or did not do. The issue is that Cameron said, very aggressively, that he could not be accused of depriving sick children of health care because of his own personal experience. The evidence however is that very ill children are daily being deprived of anything approaching adequate health care, which is totally inconsistent with Cameron's claims.

[Isitmebut]

If there were 13,000 beds in 2008 than there was in 1999, the population using the health service has increased by several million and there was a honking great annual budget deficit in 2010 that was no where near as large in 1997 - so how can in not be anything to do with Labour and the services the NHS provides?

Isn't this more of a Mental Health issue, which has been found wanting of more cash, or did that not suit your agenda to show Cameron going back on his word?

BTW do you doubt Cameron is sincere re the NHS with the needs he had with his son?

As I had a child that needed Great Ormand St soon after birth (and outpatient for many years after) for a relatively minor sight defect compared to all the other children we saw there - and I know how much I owe them.

Think how worse it could have been WITHOUT even ring fencing NHS spending in 2010 as Labour (then) suggested, with all this extra demand they also forgot to build new homes for.

The economy would also have pan-holed so even the £100 bil annual budget BEFORE increases would have been at risk and subject to CUTS, as in Greece, Portugal and Spain, with cuts up to 17%.

[Isitmebut]

A real political scandal is when the NHS screws up when money is no object and a government either fails to anticipate future demand or is incompetent running it - guilty of both, is criminal.


July 2013 “Labour's NHS denial machine: Expert's verdict of ministers who 'covered up problems at failing hospitals as thousands died'

www.dailymail.co.uk/news/article-2363808/Labours-NHS-denial-machine-Experts-verdict-ministers-covered-problems-failing-hospitals-thousands-died.html

• Prof Sir Brian Jarman said health ministers tried to stop NHS criticism
• Report by Sir Bruce Keogh tomorrow will reveal failure at 14 hospital trusts
• The trusts are 'responsible' for up to 13,000 ‘excess deaths’ since 2005

[Icimoi]

Isitme, is there any chance you might pay some attention to the people who are in charge of the health service now and who have been in charge for the last 4 years 8 months?

[Isitmebut]

Icimoi ….. there is every chance of that, as the firing of 20,000 NHS managers and increase in several thousands of more doctors and nurses can be attributed to those in charge now – as just one example of priorities.

Is there any danger of you realising that after a General Election there is no magic ‘reset’ button back to 1997, and the legacy left to the Coalition on ALL major policy areas, not just the NHS, was a shambles - including the NHS Trusts and annual PFI budget restraints/waste for decades to come, mentioned within posts above?

But back to your main point of this thread;

One could doubt the political convictions of a political party leader, from a Marxist family, wanting to impose yet another property tax on aspiration, when he and his family had nicely tied up his large, expensive family homes in tax efficient trusts.

One could doubt the political convictions of a party leader who swapped/married/imported an English wife for a German model, but don’t think every other English citizen should have one.

But to blame Cameron for every bad local decision involving children and use that to dismiss Cameron’s political conviction on the NHS, with a special mention for children - based on his own NHS experiences with a special needs child he has since lost - is frankly SICK, gutter politics at its worst. IMO

[Thecatisatwat]

But Icimoi do you not understand that because of the PFI deals struck under the Labour government, to a degree any government in power in the next 20 years + has no real control over NHS spending?

Which is why I find it hilarious when people warn that the tories will privatise the NHS. Why do they need to when Labour have already done such a good job of it?

[Icimoi]

The issue, Isitmebut, is that Cameron has very loudly and vociferously been claiming that he would not put health services for children at risk, and he has undoubtedly done that and more. So yes, we can blame him, because he has pinned his colours so very firmly to that mast. And it is of course Cameron who brings his children into this issue, not anyone else.

[Isitmebut]

Icimoi ….. OK I get it, this is a combinational of the old PMQT sham of mention an individual case, of say a Tessa Trollybus in Scunthorpe, and rubbishing a whole policy that has worked for millions PLUS a ‘well as Cameron mentioned his personal NHS experiences with a special needs child, he is fair political game’. How very typical.

Does that mean that I, in good political could say after Gordon Brown told us that he nearly lost his sight in Number 10, that that would explain his profligate ‘short sightedness’ over several years – and complete social ‘lack of vision’ that will affect ALL OUR CHILDREN for generations to come?

Not really, and factually the Brown criticism is far more accurate than doubting Cameron, through DIRECT experiences, wanting every person, including every child, to get good care by the NHS.