Theresa May’s mental health act reform: Warm words but scant action

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You may well have missed it under the Brexit deluge but Theresa May announced a major reform of the Mental Health Act this month – the first for 30 years.

Sir Simon Wessely, a tame report on reviewing the mental health act

She had commissioned Sir Simon Wessely, Regius Professor of Psychiatry at King’s College London and president of the Royal Society of Medicine to examine the legal state of Britain’s mental health system.

His report came out earlier this month. Frankly it is full of warm words but proposes scant action and dumps the problem of better treatment for mental health patients on the NHS.

The good part of his report is that it does give better rights for patients held under community treatment orders. and some useful changes when mental patients die in police custody including restoring non means tested legal aid to challenge the authorities.

The bad part of his report is that it fails to offer a solution to what is one of the most glaring problems in the mental health service – the vast number of Afro-Caribbeans who are sectioned compared to the majority white population.

It acknowledges it exists and in his introduction Sir Simon Wessely quotes the view of one ethnic minority person who told him “for a black person, a psychiatric hospital is seen as the place where they drug you up, and at worst even kill you”.

He goes on to confirm that nothing much has changed in 30 years.

“it is sad to record that little has changed. There does appear to be more consensus that this increase is real, and not an artefact, and also that it is related to experiences of discrimination, exclusion and racism. There is also consensus that even taking this into account, the use of coercion is far greater in this population, finding its most painful expression in the statistic that those of black African or Caribbean heritage are over eight times more likely to be subjected to Community Treatment Orders than those of white heritage. In other words, too often and in too many areas the experiences of those of black African and Caribbean heritage is one of either being excluded or detained.”

He then admits institutional racism exists even if it is unconscious but the main body of the 307 page report does not address the issue of why psychiatrists accept that Afro-Caribbeans are eight times more likely to be schizophrenic or suffer from psychosis than anyone else. Nor does it propose any remedies for this particular problem. You can read the report via this link.

institutional racism

As Suman Fernando,a psychiatrist and author of a major work on institutional racism , put it:

Suman Fernando. Pic credit: http://www.sumanfernando.com

” The first question to be asked is whether this report would have had the same approach to ‘race’ if the victims of institutional racism had not been ‘black and minority ethnic’ people but a white minority / majority group?   The issue here is about white privilege and power. And the question arises as to how this systemic failure of an official report has come about.  Second, who carries responsibility for the failure of this report to have race on its agenda for change? “

He concludes:” This Review has raised false hopes in the minds and hearts of many black people “

Consultations on this report will begin in the New Year with legislation to follow. But it will get nowhere without a big commitment to resources and a change of culture and attitudes by psychiatrists treating patients.

As Norman Lamb, Liberal Democrat health spokesman put it: “In the Government’s response to the Review, there must be a commitment to invest more money to support those at crisis point and help people before they reach crisis point. The Conservatives to date have failed to adequately invest in Mental Health. Without strong goals and commitments from the Government, rising detention rates will not be adequately challenged.”

tame conclusions

My conclusion is that both Theresa May and Simon Wessely are speaking from the same song book. They are prepared to speak warm words about the problem but are not prepared to take radical action to solve it. No wonder he can calmly state that no political influence was brought to bear on the report. It wasn’t necessary given its tame conclusions.

Last of the Summer Time: The next new EU row for Theresa May

Theresa May about not to enjoy a row over summer time Pic Credit: Articular/ Freepik

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As the UK and the EU come to a deal on the withdrawal of the country from the EU the practicalities of the arrangement are about to rebound on Theresa May.

The European Commission  are planning  a new directive that will affect everyone in the UK and Ireland and from March 29 when the UK ceases to be an EU ” rule maker” and becomes a ” rule taker” it can do nothing about it.

The EU want to change our time. They want to standardise time across all countries by abolishing the move in the UK from Greenwich mean time to summer time – keeping the same hours for the whole year. While the EU will still respect different time zones – Brussels is normally one hour ahead of the UK – it no longer wants any difference  between summer and winter time. The UK could decide to adopt permanent summer time but this has proved unpopular in the past.

And one of the byproducts of this is that Ireland could have two time zones if Britain doesn’t agree -a sort of new ” time border” that because of the complexities will mean some farms that straddle the border will be working in two time zones.

Not surprisingly the UK does not want this. But with all the excitement about  the enormity  of Brexit we are not going about making our views known very well.

The future of this massive change – which would mean darker evenings and  lighter mornings – has been left to the most junior of ministers, Kelly Tolhurst, the MP for Rochester and Stroud and a Parliamentary under-secretary at the Department of Business. She has only been an MP for three years and a minister for just six months.

And the only discussion about this in Parliament has taken place at an obscure committee meeting a week or so ago where she did not particularly distinguish herself.Parliament has passed a resolution without debate in the chamber objecting to the move – but who in the EU will think they have to take much notice.

It has arisen because since 1980 the EU has had some  competency to  regularise time to help business and now wants to extend its role to end the ritual of clocks going forward and backward across the EU.

The pressure has come from the Germans, the French and the Austrians who, according to a survey, are fed up with changing the clocks twice a year.  The UK, it emerged, had objected at a meeting in Graz in Austria and has so far got the support of Greece and Portugal.

But time, no pun intended here, is running out. A decision will be taken in March and implemented later next year during the transition period when the UK has to accept all new EU rules.

Worse though was the reaction from the minister to telling the people of the UK about what is under discussion.

She came under repeated questioning from MPs, notably Stella Creasy, Labour MP for Walthamstow, and Michael Tomlinson, Conservative MP for Mid Dorset and North Poole, to launch a consultation about the changes. But she refused to do it.

” Currently we do not intend carry out a consultation. We are working with other member states to block the proposal. Obviously, we will respect the implementation of EU rules while we are still a member but at this moment in time we do not want to consult because we are fundamentally against the proposed clock changes.”

This extraordinary position was even worse for Northern Ireland which could find itself in a different time zone to the Republic because Stormont is suspended she is not even proposing any guidance.

Instead she insisted that the UK  would be successful in blocking it – ignoring the fact that after March 29 the UK won’t be in a position to do so.

Patrick Grady, SNP MP for Glasgow North, pit it succinctly: ” Once we leave the European Union—if the United Kingdom finally leaves—there will be nothing to stop there being different time zones across the island of Ireland, because the United Kingdom will no longer be in a position to have the kind of influence that the Minister has been speaking about, to work with other member states to come to an agreement that this is not necessary. Once we are out, we will have no say in those discussions whatsoever. ”

So I predict a  perfect storm after we leave. The only way we can stop it – if you are a Brexiteer is to press for a ” no deal” situation. The only other way to stop it is if you are a Remainer is to stay in the EU and demand a derogation from the decision which is perfectly possible.

The one way to be forced to do this is Theresa May’s present solution  which leaves UK as a ” rule taker” rather than a ” rule maker”. This I suspect will be the first of many issues that will cause massive problems. And changing our time affects everybody in the UK. For those who want the full details of the debate here’s the video of the European Committee meeting on November 12 that discussed it, courtesy of parliamentlive.tv

Race equality groups seek big changes to the mental health act to end stereotyping and over-medication

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Sir Simon Wesseley, planning to report on reviewing the mental health act later this year

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While Theresa May is battling to hold her line on Brexit her almost unreported initiative to reform the mental health act is leading to demands for the government to introduce radical reforms for treatment and new rights for patients.

A submission from Race on the  Agenda and the Race Equality Foundation to the review  by Sir Simon Wesseley, set up by Theresa May to look into why so many black Afro Caribbean people were being detained in mental hospitals and the need for changes to the Act. It also comes against a disturbing background of deaths in police custody.

The submission has been backed by the Runnymede Trust;Patrick Vernon OBE, Chair of the Labour Party’s Race Equality Advisory Group, writer Amy Kenyon and Professor Rachel Tribe, of the School of Psychology at the University of East London among others.

NEED FOR BIG CHANGES

The Downing Street interim report  contained many warm words but not a lot of action. It stated: “Experience of people from black African and Caribbean heritage are particularly poor and they are detained more than any other group. Too often this can result in police becoming involved at time of crisis. The causes of this disparity are complex.” The  full report  and details of its members  and terms of reference is available here.

Now the submission to the inquiry proposes major changes to tackle the problem. The link to it is here. The main proposals are:

1. The Mental Health Act (the Act) should set out principles that define human rights, anti-discriminatory practice and a commitment to combat institutional racism.
2. The Act should be amended to include a clause that states explicitly that a diagnosis for a ‘mental disorder’ must take account of the patient’s social and cultural background. And the Act should allow for appeals against diagnoses via a Tribunal, with a panel that includes experts from BAME backgrounds.
3. Patients detained under the Act should be empowered to choose which carers or family members have a say in their care and can support them during an appeals process.
4. A new system of appeal whenever a new diagnosis is applied and/or continued, to a tribunal-like body, with the right of the patient concerned to have legal representation at the hearing.
5. All mental health service providers should be set targets to reduce the use of Community Treatment Orders and minimize racial inequalities in their use. This should be monitored by the Care Quality Commission  during inspections. Specific amendments in relation to supervised treatment in the community should be made to ensure this is statutory.
6. Statutory bodies should be regularly inspected by the CQC or other appropriate body to ensure that training of professionals working in mental health services addresses issues of racial bias and cultural competence.

The  submission  says: “:We were glad to see an emphasis on the urgent need to address the disproportionate number of people from black African and Caribbean backgrounds being detained under the Mental Health Act (MHA).

Equally, we were unsurprised that Black, Asian and Minority Ethnic (BAME) focus group participants highlighted a lack of cultural awareness in staff and a need for culturally appropriate care as paramount. We would express concerns about racism, stigma, stereotyping and overmedication. We hope that these findings will guide and underpin the recommendations made in the final report ”

It is to be hoped that Sir Simon and Theresa May do take action to remedy these many faults in the system. Otherwise it will be another case of political posturing  like help for the ” just about managing” which has so far amounted to warm words and little else.

There were concerns expressed at the recent conference organised by Rota at the University of East London that little would really be done to tackle this. If little happens it will only make matters worse and there is a need for strong campaign to make sure Downing Street does really listen.

Government narrowly defeat plan for new Leveson inquiry after deal with DUP

Lord-Justice-Leveson

Lord Justice Leveson ; Pic courtesy Leveson Inquiry website

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UPDATE: Government defeated the Leveson2  inquiry by nine votes 304-295 . There were five Tory rebels. The nine DUP  MPs supported the government after they were offered a new press watchdog for Northern Ireland. The one independent Northern Ireland MP, Lady Hermon voted with Labour.

Five Tories voted with Labour – they were Ken Clarke, Dominic Grieve ( former attorney general), Peter Bone, Philip Hollobone and Crispin Blunt.

One Labour MP John Grogan voted with the government to block Leveson 2.

Parliament will decide today whether a second Leveson inquiry  should go ahead and on new rules that would strengthen the role of press regulator Impress and force compulsory arbitration in libel cases.

Voting in the Commons on both motions is on a knife edge with  literally the decision being made on who turns up and whether very active campaigns by  mainstream media moguls or Hacked Off can convince wavering MPs.

Theresa May has staked her reputation on protecting Murdoch and Dacre from a second Leveson inquiry into malpractices by the media and scrapping the section which would have forced compulsory arbitration. At the Westminster  Correspondents Dinner she promised lobby journalists that ” very good news” was coming to help the media moguls avoid further scrutiny into their practices.

But her failure to control Parliament has put both promises at risk- hence the frenzied campaign  in the media to protect press freedom by media bosses who do not want some of the dark practices subject to forensic examination by Lord Leveson.

There are two motions today – one by former Labour leader Ed Miliband and Tory rebel Kenneth Clarke – aims to reinstate Leveson 2 after a Commons committee overturned a Lords resolution to hold the inquiry.

The second by Tom Watson, Labour deputy’s leader and long time campaigner against the Murdoch press, would implement the changes promised to force compulsory arbitration in libel cases – making court cases very expensive for the media even if they won.

The first motion stands the best chance of passing with guaranteed support from a number of Tory rebels, Labour, the Liberal Democrats, the sole Green MP, Plaid Cymru and the Scottish Nationalists. Nobody seems sure how the DUP will vote.

This alliance is however dependent on everybody turning up and solid support among all the groups.

There was signs at the weekend  that media moguls had changed  tactics and were trying to persuade some Labour MPs not to back Ed Miliband’s motion and the one strengthening Impress-and suggesting this would go down very well in the mainstream media who might look favourably on covering some of the issues  these Labour MPs might want to take up. A senior Labour source told me : ” They (the Labour MPs) are trying to curry favour with the mass media”.

Labour whips have been alerted to this but some Labour MPs are playing their cards very close to their chests and trying to hide their proposed support. You can be sure there will be very active work done by Labour this morning to try and root them out.

The other problem  that could scupper a  defeat for the government will be if not all MPs turn up. Here the SNP with 35 MPs are a key group – but not all of them turn up if they have pressing business in Scotland. A  ” no show” by just a few in this group would have a big effect on the vote.

So today’s decision will depend on the capricious nature of MPs in Parliament – and how much priority they put into defeating the government over this issue.

 

 

 

 

50’s Women:”Nobody will see their pension entitlement changed by more than 18 months” – Theresa May’s crass error

theresa may in parliament

Theresa May in Parliament Picture YouTube

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There was an extraordinary error by the Prime Minister, Theresa May, when she was challenged by Ian Blackford, the Scottish Nationalist leader, at Prime Minister’s Questions in Parliament today.

Mr Blackford used one of his two questions to raise the plight of the 3.8 million WASPI women who have been hit by the government’s  decision to raise the pension age from 60 to 65, then 66 and 67.

Mr Blackford asked: “Yesterday we celebrated the achievements of the suffragette movement, which was about democracy, equality and fairness for women.

“However, today in the United Kingdom, 3.8 million women are not receiving the pension to which they are entitled. A motion in this House last November, which received unanimous cross-party support—the vote was 288 to zero—called on the Government in London to do the right thing. Will the Prime Minister do her bit for gender equality and end the injustice faced by 1950s women.”

The Prime minister replied:

“As people are living longer, it is important that we equalise the pension age of men and women. We are doing that, and we are doing it faster. We have already acted to give more protection to the women involved. An extra £1 billion has been put in to ensure that nobody will see their pension entitlement changed by more than 18 months. That was a real response to the issue that was being addressed. If the right hon. Gentleman wants to talk about equality, he has to recognise the importance of the equality of the state pension age between men and women.”

What this showed is what 3.8 million women waiting up to SIX years for their delayed pension have yet to get the message across. Theresa May just thinks you have a little wait of 18 months. And this £1.1 billion  concession is just a future cost to the government over the next two years, no money has been paid out yet.

This ignorance – caused by her only taking into account the changes in 2011 affecting the rise in the pension  age from 65 to 66 for both men and women – shows how ignorant the Prime Minister is.  Considering she is in that age group herself – but guaranteed to get a large Parliamentary and Prime Ministerial pension in her right-plus a big payout for her wealthy hubby – shows the gulf between the Metropolitan elite and the ordinary person. Mo misery for her in her old age.

But it was good news that the SNP leadership were taking women pensioners plight seriously. About time Labour and Liberal Democrats did the same.

UPDATE:  Ian Blackford said today (Thurs) : ” The Prime Minister’s reply was outrageous. She was being economical with the truth. We are all know there have been some horrible cases as a result of this policy and something will have to be done.

“I am not just sympathetic I will not let this matter go.”

Later Guy Opperham, under secretary for works and pensions, made a statement in Parliament saying  the government were  not going to do anything and would fight any legal challenge by the 3.8 million people to change its mind. He was cagey about announcing the last date when people who were never told about the change until years afterwards could complain about maladministration.

Watch him and the short debate that followed here

Guy Opperman has a majority of 9,286 over Labour in his Hexham constituency in Northumberland. There are 6000 constituents who are 50s women and have suffered from a policy he has no intention of changing. If they all switched to his nearest challenger he could lose his seat. That is up to you.

The top Tory power grab that turns their party members into mere pawns

Rob Semple and Theresa May

Rob Semple, chair of the Conservative Party Convention, and Theresa May – the ” Old Elizabethans” Pic credit: Twitter

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Update December 21: Since writing this piece I have discovered that the Conservative Home website, had already raised  objections to the power grab a few days after the convention. The link to their story is here .

 It is good news  for democrats everywhere that  some Conservatives are challenging this. For avoidance of any doubt my Conservative source and myself were unaware of this when I published the story.

While  the public and press have been absorbed in Tory battles over Brexit the top hierarchy in the Conservative Party have mounted an extraordinary power grab behind the scenes that strips their ordinary members of any meaningful say in the running of their organisation.

On November 25 the party held a convention in Birmingham attended by 100 invited people which rewrote sections of the party’s constitution. For policy nerds I attach the document sent out by Rob Semple, chairman of the Conservative Convention and deputy chairman of the Conservative Party Board. I have also written about this in Tribune magazine.

Masquerading as ” small suggestions to bring us into the 21st Century “the convention agreed to rewrite the party constitution to remove references to constituencies altogether;limit the right of local associations to choose their own candidates and scrap the annual meeting of the Conservative Convention where people could listen and vote for candidates for top posts. Instead on line voting would be used for all top posts in the party.

The changes will go for final approval next March at a meeting of the Conservative Convention and will be put to MPs at a meeting of the 1922 Committee in Westminster the same month.

The Tories are hoping that by removing the word constituency from the constitution it will encourage people to form wider associations – which has had some success in Kent where six associations in the Thanet area have combined. But it also reflects the dire state of activists in some Tory constituency associations – where a number have now fallen to fewer than 50 members and operate from a P O Box address.

 The change in selection proposed in the constitution gives power to the candidates committee of the Board of the Party – whose members are appointed rather than elected. The new wording is:“The selection of all candidates, including Parliamentary, Police Commissioners, Elected Mayors and local government candidates shall follow a process in accordance with rules and guidance published from time to time by the Committee on Candidates of the Board of the Party.”

Not surprisingly the proposals have been  vehemently attacked  by Tory members who quite naturally believe if they join a political party – they should have some say in its policies and be able to choose their own candidates.

John Strafford, chairman of  Conservative Campaign for Democracy. said: “If these proposed changes are not voted down you might as well say The Conservative Party: The End”

 “And if MPs don’t take any action to stop these proposals they will find the only activists campaigning for them at the next general election will be themselves.”

 I did contact Conservative Central Office last week  for a comment but there has been no response and there does not appear to be a press release.

And in addition the review  into the failed General Election campaign by  Sir Eric Pickles, the former MP and chairman – probably about to be made a peer by Theresa May – contains one extraordinary overlooked proposal.

It suggests the Tory Party – which wasted £4.5 million on consultants to the failed campaign this year – could hand over lock, stock and barrel – the running of the next campaign to a private company.

This frankly is an extraordinary state of affairs in British politics for the 21st century.

Two parties – Labour and the Liberal Democrats – will fight the next general election with  the largest number of members and supporters  they have had for ages- reflecting a democratic revolution.

The top Labour Party people will be elected by the membership – there is an election for the National Executive Party going on now. So will the candidates.

But the  cash rich Conservative Party will basically turn itself into an unelected commercial organisation – where investors and private companies will decide the presentation of policies for the people.

The contrast could not be much starker. Labour will go into the next general election as a mass movement with a mass membership who can influence policy and decide on who stands for Parliament, the police and the local council.

The Tories go into the election as a small clique with their members little more than cannon fodder.

A libertarian academic suggested to me that the Tories had turned politics back four centuries – to the days when the Elizabethans and the Dutch Indies companies – used private investors to  create a joint enterprise to rule parts of the globe and general populus had no say. What an achievement in 2017.

 

 

 

 

Hillsborough Families:Patronised to death by the disdain of the powerful

hillsborough.pic credit ITV

A Liverpool football shirt commemorating Hillsboough. pic Credit: itv.com

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While Westminster was yesterday swirling with tales of sexual harassment by powerful ministers and MPs and the arrogance of a government that won’t tell us what will be the real effects of Brexit, a calm but hard hitting report was published on what had happened since the revelations of the Hillsborough disaster.

The scandal of the deaths of 96 Liverpool fans who went to watch a football match 27 years ago is well known and now well documented following the Hillsborough Independent Panel which  exhaustively looked at what happened.

Since there are now criminal proceedings against people following the disaster I am not going to rerun  who was to blame for these needless deaths but concentrate on what yesterday’s report was about – what should be done.

There are many reports exposing what goes wrong. There are fewer reports proposing how to remedy serious shortcomings. There are even fewer that  demand a cultural change in British society.

This is one of them. The gruesome testimony in this report of the families who lost loved ones well before their time demands nothing less than a radical change in the way the ruling elite view ordinary people.

People caught up in a tragedy are confused, distraught. angry and suffer lifelong angst   and the last thing they want are people in power who frustrate, ignore, belittle or patronise them for wanting to know what happened to their loved ones. The Hillsborough families also had to put up with  very public denigrating coverage from the Sun  which has never been forgiven in Liverpool.

This report shows a way  change can come and outlines the legislation needed to get it done. The recommendations – if implemented in the right spirit – would make a radical change in the way society coped with  the aftermath of disasters – whether it is Hillsborough or the Grenfell tower fire tragedy.

The proposals go from introducing a ” duty of candour” for police officers to tell the truth, providing proper legal aid for ordinary people attending inquests so they can really participate in the proceedings and a special charter for families who suffer bereavement in a major tragedy like Hillsborough.

It also wants to make sure authorities don’t destroy vital documents to avoid public scrutiny, better training and evaluation for coroners, a review of the  effectiveness of  the pathology services and the way death certificates are issued. Nor should public bodies use public money to their advantage to outspend ordinary people trying to get to the truth.

Two other things should be said. Theresa May, whom I may  disagree politically, should be commended for commissioning this. She could easily have walked away once the Hillsborough Panel had done its work. Liverpool football fans are not her natural constituency. She will be even more commended if she decides to implement its findings.

There is also an remarkable passage in the introduction from the  report’s author, the Right Reverend James Jones, the former bishop of Liverpool and chair of the Hillsborough Inquiry which sums up the spirit of the report and what the families have suffered. It is worth quoting in full :

“I also wanted to set on record a recurrent theme that has been present, either implicitly or explicitly, in many personal conversations that I have had with families and survivors over the past 20 years.

“It is one that they have often been reluctant to raise not least because of public and political indifference to the subject and perhaps out of fear that it would add
to the lack of empathy that they experienced. The disaster, the aftermath, and the struggle to be heard for over quarter of a century have had an adverse effect on the mental and physical well being of both families and survivors.

“Depression, marital breakdown, family division, mental illness, unemployment, premature death and even suicide have featured in the Hillsborough narrative. Hopefully society’s increasing awareness of the issues of mental health will lead to a more sympathetic understanding of what they have endured.

“People talk too loosely about closure. They fail to realise that there can be no closure to love, nor should there be for someone you have loved and lost. Furthermore, grief is a journey without a destination. The bereaved travel through a landscape of memories and thoughts of what might have been. It is a journey marked by milestones, some you seek, some you stumble on. For the families and survivors of Hillsborough these milestones have included the search for truth, accountability and justice. But even these are not the end of the road.They are still travelling. And this report is another step along the way.”

You can read the report for yourselves here .