In her deputation statement to the Calderdale & Kirklees Joint Health Scrutiny Committee yesterday, the Chair of Calderdale 38 Degrees NHS Campaign warned of the risk that the plan to move many services out of the hospitals into the “community” would repeat the the disastrous Care in the Community scheme of the 1980s/90s, that resulted from the closure of mental health hospitals.

Jane Rendle told Councillors:

“Once the hospitals had closed, funding for mental health Care in the Community was whittled away, leading to inadequate care and no hospital back up. Today we have the disastrous situation that sometimes there is not a single available mental health bed in the country.”

Now, history is repeating itself.  Clinical Commissioning Groups are pushing the un-evidenced “Care Closer to Home scheme” – while effective and cost-efficient community mental health services are for the chop. Users of an NHS community-based Art Psychotherapy service in Calderdale are fighting to save it from closure after the therapists were given compulsory redundancy notices over the Christmas period.

And increasingly, mental health services are being privatised.

Privatisation of mental health care

In 2015/16, Calderdale Clinical Commissioning Group Calderdale CCG paid £1,612,525 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?

Rosemary Hedges, a retired NHS mental health worker and now Secretary of Calderdale 38 Degree NHS campaign, said:

“When Storthes Hall Mental Hospital in Huddersfield closed in 1989 the health authority re-provided 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.”

Confusion over Calderdale and Kirklees planned bed cuts for mental health rehabilitation and recovery patients

In September 2015, Calderdale Adults Health & Social Care Scrutiny Panel heard of confusion over planned bed cuts for mental health rehabilitation and recovery patients – although these vital beds are already in short supply.

At the time, Support the NHS campaigners called for the Scrutiny Panel to require Calderdale Council’s rehabilitation and recovery service and South West Yorkshire Partnership Foundation Trust (responsible for providing mental health services) each to produce:

• the  clinical evidence to justify closing 36 mental health rehabilitation and recovery beds and putting the rehabilitation and recovery service into the community
• impact assessments on patient care and staff.

It is not known whether this has happened.

Private mental health companies profit from 4%/year increase in NHS referrals

Amid the meltdown of NHS mental health services, private mental health companies have seen an average increase of NHS referrals of 4%/year for the last three years.

Independent mental health providers have seen an increase in NHS referrals following NHS England’s moratorium on commissioning new capacity for centrally commissioned specialised services.

A report published by LaingBuisson, ‘Mental health hospitals and community mental health services – 2nd edition’, that this increase was because in 2013 NHS England imposed a moratorium on commissioning new capacity for these services.

The report also points to nursing and other staff shortages driving more referrals to the private sector.

LaingBuisson estimates that NHS demand for private sector beds accounts for 87% of independent mental health care providers’ revenue. The report said:

“ The likelihood is that NHS in-house capacity will continue to decline …”

According to LaingBuisson’s report, there are currently 10,018 mental health beds across 271 hospitals in the independent sector. The UK mental health “market”, including hospitals and NHS primary and community services, was estimated to be worth £15.9 billion in 2014-15, with the independent sector share at 8.5% of that. Most independent sector activity occurs in the hospital sector, which LaingBuisson valued at £4.3 billion, with the independent sector accounting for £1.3 billion.