#NHS Detectives are on the case, collecting evidence to thwart the crime of privatisation.
Here is our report on the privatisation of some mental health services in Calderdale – some mental health hospital services, and community mental health services for Children and Adolescents, and for Adult Drug and Alcohol Recovery.
The motive for the crime – follow the money!
SInce the 1980s, successive governments have been getting cosy with private health companies, and handing over more and more NHS services to them. This has speeded up over the last two years, as a result of legislation introduced by the Coalition government.
Over two hundred Parliamentarians with vested interests in private health companies were allowed to vote on this Health and Social Care Act 2012 – which neither party had put in their 2010 election manifestos.
This Act removed the duty of the Secretary of State to provide a comprehensive universal health service that is based on clinical need not ability to pay. It also made it the law that private health companies must be able to compete with NHS hospitals, trusts and GP services, for contracts to provide health services under the NHS logo.
On top of that, since 2011 the NHS has been subejct to brutal cuts in the shape of hefty “efficiency savings” demanded by the government year on year, in order to try and pay for the 2008 bankers’ bail out.
These are the forces that are driving the privatisation of some of Calderdale’s mental health services.
Privatised mental health hospital services
This financial year, 2015/16, Calderdale CCG is paying £1,612,525/year to 5 private mental health companies for mental health hospital and care home services. Why? What’s wrong with our NHS mental health hospital services in Calderdale?
Is it that they’ve been cut to the bone and there just aren’t enough to meet mental health patients’ needs?
Calderdale’s contracts with private mental health hospitals
This financial year Calderdale CCG has a £335,400.00 contact with Caireach Ltd (aka Woodleigh Care) for Hospital Services at Woodside Independent Hospital and Kirkside Hospital.
Woodside Independent Hospital, in Bradford, provides treatments for patients admitted under the Mental Health Act or the Mental Capacity Act. Kirkside provides specialist residential care for up to fifteen people. Its Care quality Commission Report says it needs improvement.
Cygnet Health Care Ltd
This financial year Calderdale CCG has a £415,884 contract with Cygnet Health Care Ltd for Hospital Services/ Rehabilitation- Mental Health/OP/Young Adults.
Cygnet Lodge in Brighouse is an intensive community rehabilitation unit for men,
Cambian Healthcare Ltd
Calderdale CCG has a £254,158.00/year contract with Cambian Healthcare Ltd for Hospital services for the two years from 01-Apr-14 to 31-Mar-16.
Cambian Healthcare Ltd provides specialist behavioural health services for children and adults in the UK. They are listed on the London Stock Exchange and say they:
“operate a UK-wide portfolio of 249 services caring for over 2,400 individuals (23 schools, 35 hospitals, 188 specialist care homes, day services and 3 fostering offices). We employ over 6,000 employees of whom 572 sit within our clinically-led Multi-Disciplinary Team, which is the largest cohort of therapists and clinicians employed in the UK by a single organisation outside of the NHS.”
This is the list of their clinics and services
The Retreat York
Calderdale CCG has a £238,858/year contract for the two years 2014/15-2015/16, with the Retreat York Independent Hospital for persons detained under the Mental Health Act.
Calderdale CCG has a £368,225/year contract for the same two years, with The Priory (Craemoor Holme House) for Learnng Disabilities for Adults – Nursing Home. Here is info about The Priory
Info source for Calderdale CCG’s private mental health service contracts: CCCG Contract Register
Why have these services been privatised?
Rosemary Hedges, a retired NHS mental health worker and now Secretary of Calderdale 38 Degree NHS campaign, comments:
“These are truly shocking statistics. When Storthes Hall Mental Hospital in Huddersfield closed in 1989 the health authority reprovided 76 inpatient beds, a 14 bed rehab hostel and a 22 bed long stay facility. That was just for one health district. By 2010 they had all gone. Now we pay through the nose to provide profits for private companies. Its a disgrace.”
Shortage of NHS mental health beds in Calderdale
The government and its NHS puppet master Jeremy Hunt are intent on defunding, running down and privatising the NHS – despite the fact that 88% of the public and 77% of Tory voters and supporters want a publicly owned and run NHS, according to a YouGov poll. The privatisation of mental health services in Calderdale is part of that pattern.
In 2014/15, Calderdale Clinical Commissioning Group paid the mental health Trust 1.5% less than it did in 2013/14. This was despite the fact that the mental health Trust was seeing more patients than planned.
In May 2014, Upper Calder Valley Plain Speaker reported a massive shortage of beds for mental health patients in Calderdale and Greater Huddersfield.
As of September 2015, due to current bed shortages, 11 Calderdale patients were in rehab and recovery placements outside our district, or in private facilities in Calderdale such as Cygnet Lodge in Brighouse.
Calderdale CCG has a £415,884 contract with Cygnet Health Care Ltd (more info below, under the heading ‘contracts with private mental health hospitals’).
The NHS mental health trust, SWYPFT, and Calderdale Council’s Rehabilitation and Recovery Service have announced their aim to move patients out of rehab and recovery accommodation into their own homes, supported by ‘a flexible community offer’ – whatever SWYPFT might mean by this jargon.
The Council proposes that mental health patients will pay for this community support using means-tested personal social care budgets and non-means tested personal health budgets.
The Clinical Commissioning Group can allocate Personal Health Budgets (PHBs) to patients who need ‘continuing care’. The CCG gives patients the amount of money that would otherwise have been spent on their NHS care. The patients can then buy their care from wherever they see fit. PHBs are allow for a move to the private insurance model and are a key part of the privatisation of the NHS.
Very few continuing care patients in Calderdale have so far asked for PHBs, but this move by Calderdale Council looks as if it will force mental health patients with continuing care needs to apply for PHBs.
Privatisation of community mental health services
SInce 2014, Calderdale Council has privatised the Tier 2 (Community) Child and Adolescent Mental Health Service, and the Integrated Adult Drug and Alcohol Recovery Oriented Service. Both were previously provided by the NHS mental health trust.
With these two contracts, Calderdale Council is spending more than £10m over three years on privatised mental health services.
But it has cut the funding for these services by privatising them, and in the case of CAMHS Tier 2 has also cut some services.
Child and Adolescent Mental Health Services (CAMHS) community (Tier 2) service – cutting costs, cutting services
In 2014, Calderdale Clinical Commissioning Group and Calderdale Council, joint commissions for Tier 2 (Community) Child and Adolescent Mental Health Services (CAMHS), contracted it out to a charity, Leeds Counselling Services, with a three year contract worth £1.11m.
This was after the NHS mental health trust, SWYPFT, gave notice that they no longer wanted to continue to provide this service. It was beset with problems of long waiting times and poor patient experience. This was a national problem, with CAMHS in crisis throughout England.
Privatisation has failed to solve the problems. These showed up red, as a level 16 risk, in the risk log for Calderdale Clinical Commissioning Group’s June 2015 meeting. Calderdale Clinical Commissioning Group (CCG) also pointed to the problem of care being fragmented between the different CAMHS providers.
In the process of privatising Tier 2 CAMHS, Calderdale Council cut Sure Start Counselling Services for children, young people and parents from 30th September 2013, because funding was no longer available for them.
And some other services are now no longer free, but according to information from Calderdale Council, are:
“available for commissioning or can be purchased by client, school or family”.
More info here about these services.
The Council was unable to say how much CAMHS tier 2 funding was cut in the new outsourced contract, or whether there has been a change in the take-up of services that used to be free but that users now need to pay for. This is because the Council doesn’t know how many children and young people used Tier 2 CAMHS before the service was privatised. They say the CCG has that data, as the previous commissioner for the service. You’d have thought the Council might want to ask for that info.
Integrated Adult Drug and Alcohol Recovery Oriented Service – cutting costs
In 2015, Calderdale Council privatised the Integrated Adult Drug and Alcohol Recovery Oriented Service. The Council is out to cut the costs of its public health services, in order to redirect the ‘savings’ to other parts of the Council that have run out of money, due to the government’s savage cuts to Council funding.
Calderdale Council awarded a 3 year contract worth £8, 971, 374 (excluding VAT) to Developing Initiatives Supporting Communities (DISC) as the “lead provider”. DISC subcontracts the actual work to the Basement Recovery Project and St. Martin’s Health Care. The Council’s Public Health Officer reported that:
“The new procurement will release in region of £300k [ per year] to support council savings.”
The NHS had previously provided most of the treatment services for drug and alcohol misusers and out of area placements – the South West Yorkshire Foundation Partnership Trust ran Calderdale Substance Misuse Service (CSMS).