No Quibble

So the final piece of the legal jigsaw is in place (barring an unlikely rebellion in the National Assembly), namely the Code of Practice for Parts 2 and 3 of the Mental Health Measure. See all the details here.

The final version is a considerable improvement on the draft (which in fairness had much to recommend it). As well as a lot of tidying up and clarification the final version addresses the crucial need for clear timescales for the appointment of Care Coordinators (2 weeks) and completion of Care and Treatment Plans (6 weeks).

This was a great concern to Hafal's Members as we foresaw the spectre of Health Boards arguing that it was "reasonable" to take months to complete a Care Plan - and for all we knew a judge, asked to adjudicate if a patient challenged this in court, might have been bamboozled into agreeing with the bureaucrats.

Veteran Hafal activist Lee McCabe, with the support not just of Hafal but of the Mental Health Foundation and Bipolar UK, delivered a punchy campaign on this and related matters during the consultation on the Code and received huge support. It's to the credit of the Welsh Government that they listened and took action on timescales.

For clarity the timescales aren't absolute in the sense that the law is breached if ever the timescale isn't met (and we didn't argue for that) but the timescales have great meaning because, put simply, there needs to be a good reason for exceeding them. And a judge would use the timescales in the Code as the default position on what was reasonable. So woe betide LHBs which routinely exceed the timescales - that will be a breach of the law.

Lee and his supporters didn't get everything we asked for. In particular the Code isn't wholly emphatic about ensuring that Care Plans are truly holistic. The Code does require that the Plans are holistic but we would have liked to have seen crisp advice about what that means - specifically that the eight "life areas" in the Care Plan template are routinely or normally addressed in writing. But this isn't a lost cause. We need to ensure that the understanding of the word "holistic" is crystal clear in practice - so, for example, who could disagree that you can't really call a Care and Treatment Plan holistic if it fails to set out plans for such vital matters for a person in secondary mental health services as accommodation, social life, finances, etc?

So, let's not quibble but rather let's support both patients and practitioners to take mutual advantage from the new law by creating fantastic Care and Treatment Plans which deliver what patients need to achieve recovery and clarify who is doing what - because of course it isn't just for the Care Coordinator to deliver but for the patients themselves, their carers, and a range of other supporters within and beyond mental health services. There is great advantage to the Care Coordinator as well as the patient in formally enjoining that wider support rather than relying solely on the scant resources within secondary mental health services...

Razzamatazz

Compared with the exquisite excitement and relentless razzamatazz which surrounds our local council elections next week the French Presidential election a couple of days later (they vote on Sunday - these secular republicans have no truck with sabbatarian strictures) is a slight affair but for all that I quirkily find it interesting.

In the first eliminator round 1 in every 3 French citizens voted for the fascist or communist candidates, presumably out of nostalgia for the Vichy and Soviet dictatorships respectively, and now the remaining two candidates have to scrabble around to get these voters' support, not an edifying spectacle.

Everybody has written off President Nicolas Sarkozy but I'm not so sure and might put a bet on (if the odds are long enough) as I feel that he could yet steal it. The maths for me are that Sarko should keep his current 27% and add 12 of the quite-glamorous-but-fascist Marine le Pen's 18% (not all 18 because she's not backing him) plus half the centrist Bayrou's 10% plus half the remaining 12% making 50%. His socialist rival Francois Hollande will keep his 29% and take 10 of communist firebrand Melenchon's 11% plus half the centrist's 10% plus half the remaining 12%, also making 50%. BUT everybody agrees that the French vote "romantically" in the first round but in a cool, cautious and materialist bourgeois manner in the second, surely favouring the diminutive incumbent.

You may doubt me but let me remind you that Seabass was placed (third) in the Grand National as I tipped here.

You will also note that I have scrupulously avoided any stereotyping here ("Hollande hops into the lead" etc), more than can be said for former French Prime Minister Édith Cresson who famously opined that Englishmen are not interested in women and 25% of them are "tous homosexuels". She didn't explain what the remaining 75% were interested in - cricket perhaps?.

Incidentally Ms le Pen is no more ethnically French than the minorities which she and her nasty party beat up on. In fact she is (wait for it) Welsh - well, Breton but it's the same thing. She comes from Brittany and her name means "head" like in Welsh and presumably she, and her disagreeable holocaust-denying father, see their name as apposite because they both wanted to run France.


Stop Press: Ladbrokes are offering 4/1 on Sarko - not really long enough but still tempting...

Today Talbot Green Shopping Park, Tomorrow The World

Evidence of Hafal staff's infinite adaptability on this link. I see that Mark describes his position with us as "quite a serious job" - rather well put and I might borrow that myself.

If his modelling career takes off we would miss him but wish him well - we can't match the rewards available to the likes of Kate Moss or...actually I can't name a male model so, Mark, you are already the best known male fashion model as far as I am concerned and, I suspect, many of this Blog's readers.

And for those of you who are even more out of touch than me and think Kate Mosse is an author, yes she is (with an "e") but Kate Moss (without an "e") is a model who pioneered the "heroin chic" look a few years ago.

Voting Is Good For You

More about those local elections. There is a real worry that in these difficult economic times Councils might neglect people with a serious mental illness in the hope that the NHS will provide. That has always been a problem in some areas and in today's circumstances it is all the more important to hold Councils to account and make sure they serve the most vulnerable people in our communities. And there is no better opportunity to do that than at election time when the tables are turned and the candidates look for your support!

There are many decent men and women of all political parties and none already serving as Councillors or standing for election on 3 May but please don't be too deferential - press hard for their commitment to these priorities and indeed for any specific needs you perceive in your community...

1. We need a commitment from local councils to preserve and enhance services for those with the highest needs, including those with serious mental illnesses such as bipolar disorder and schizophrenia. Local councils have a duty to focus their resources on the most vulnerable.

2. Social services need to play a full part in supporting people with a serious mental illness – in partnership with the NHS – by providing responsive services which empower people to live independent lives. Every social services department in every council needs to ensure that mental health services are well-resourced. Every department needs a strong lead for mental health to represent the interests of service users and carers at the heart of social care provision.

3. Local councils need to support the delivery of the new Mental Health Measure (Wales’ new mental health law). The new law gives secondary mental health service users in Wales the right to a care plan which set goals in all areas of life. Local councils can support service users by providing excellent services in these life areas – for example, they should provide a range of quality housing, education and leisure opportunities which are accessible to people with a mental illness.

4. Local councils need to support carers. They must provide carers with assessments of their needs and provide a range of support which meets those needs. Councils also need to ensure that when they implement the Carers Strategies (Wales) Measure, specialist information, guidance and support for carers of people with a mental illness is provided.

5. Local councils should promote choice. They should extend choice and control to mental health service users not only through direct payments but by providing a flexible and responsive approach to commissioning services on behalf of individual service users.

Hafal has a long track record of encouraging participation in elections not just because the results matter but because it's important for individuals to be a part of the decision-making in their community and country, not just the passive recipients of what our leaders choose to dish out to us. Fundamentally VOTING IS GOOD FOR YOUR MENTAL HEALTH!

Lapdog

Apologies to regular readers for the long gap. Blame the mobile reception at the Travelodge in Colwyn Bay where the Orange toggle on the lapdog (as I call my portable pc) can only muster a 1990s-style "dial-up" speed which these days seems like the Golden Age of Steam.

I was up there to meet local managers and Trustees and to visit a new service in Wrexham - all very inspiring and a tribute to our staff and Members in North Wales. Also (tempting fate!) it is gratifying to note the friendly and efficient working relationship between our North Wales Office and Hafal's Head Office in Neath, not something you can take for granted and indeed all parties work hard to get this right.

While I'm up there we publish our local election Manifesto which sets out five priorities with which to badger candidates before the ballot on 3 May: take a look here and of course make sure you get out and vote Thursday week.

Driving home on Friday afternoon I repeat an occasional but longstanding ritual of this journey (25 years certainly since the first time) by stopping at the picnic site below the Sugarloaf south of Llanwrtyd Wells and walking to the top to look down on East Carmarthenshire. It's only a short climb as the road is very high up here so you get an impressive view for little effort (see above). You can see the Heart of Wales line snaking away on the right having just exited the tunnel under the mountain, the Wyddon tributary heading down the valley into the Towy, and the trunk road to the left also on a sharp descent.

Sunshine gives way suddenly to icy rain so I am instantly soaked and have to retreat quickly to the car. Back on the A483 I make my way home while blasting myself warm and dry with the heater on maximum temperature and fan settings.


Postscript:

Today on my walk I get up close to the landscape viewed at a distance on Friday...

Map, Compass And Kit Bag

Inspiring to hear that a group of intrepid mental health NHS staff from Cardiff and the Vale have kindly decided to raise money for Hafal by taking on the Three Peaks Challenge on 11 May – the same day that service users, carers and professionals will be scaling Pen y Fan, all as part of the Movin’ On Up campaign.

The Three Peaks challenge involves climbing the three highest mountains in Scotland, England and Wales namely Ben Nevis (1,344m), Scaffell Pike (978m) and Snowdon (1,085m) all within 24 hours - a phenomenal 27 miles and 3000m of ascent.

Alison Carpenter from the Three Peaks team tells us: "The Three Peaks Challenge entails the added trials of sleeping on a minibus, coping with unpredictable weather/traffic conditions, cooking al fresco and trying to get along with work colleagues whilst spending 24 exhausting hours in each others’ company!

"We decided to raise money for Hafal because the organisation provides incredible opportunities for people to embrace their lives. Pardon the pun but organisations such as Hafal provide those who have experienced mental health difficulties with a kind of 'map, compass and kit bag' which provide direction and purpose; the end goal being a retrieval of health and wellbeing."

The Three Peaks climbers – Alison, Sam Brown, Rhiannon Davies, Maria Coombes, Justin Williams, Anthony Coombes, Steven Ford, Paul Emmerson, Julie Crutcher, Darren Stevens – have set up a JustGiving page for people who would like to sponsor their challenge. Go to their link here and pledge your support!

Action Fortnight

It's all happening this summer. As fast as we get going with Movin' On Up (about secondary mental health services - see my previous post) we are also strongly engaged with Time To Change Wales (our anti-discrimination campaign with Gofal and Mind Cymru), different partners and different issues at each end of the spectrum - and yet of course both crucially important and ultimately linked.

Hafal's particular role in Time To Change Wales over the next three years is to recruit and train users and carers to deliver the anti-discrimination message through formal training sessions and informally with all their contacts in the community. But we also want to join with our partners and others to celebrate the project and spread its message in an Action Fortnight from 21 May to 1 June.

Activities could include hosting an anti-stigma information stand or workshop at a busy community centre, shop or café, or something a bit more adventurous like a myth busting quiz, a storytelling event at a local library, an anti-stigma picnic, or a mental health flashmob - sounds fun! Do go to the website linked above and get involved...

"Movin' " Gathers Pace

Last call for people interested in our Seminar which service users and carers are running in Llandrindod on 17 May 2012 with the aim of developing their continuing dialogue with senior policy makers and providers of mental health services. The Seminar is a key part of "Movin' On Up" which aims to take service users' and carers' campaigning for excellent mental health services in Wales to the next level.

Jackie James, Hafal's Carers Lead, tells me: "Last year's "Taking the Wheel" Seminar brought mental health professionals and service users together to explore how people in Wales receiving secondary mental health services could take control of their lives and the services they receive.

"This year's Seminar goes a step further: service users and carers now want to take the discussion to a new level and explore ways in which they can maximise the opportunities provided by the Mental Health Measure, the Carers Measure and the Welsh Government's new Mental Health Strategy. It will be a ground-breaking event and we expect to generate some challenging and progressive ideas."

Bringing together service users, carers, health professionals, commissioners and policy makers the Seminar will explore ways in which service users and carers can:

• Engage in the development and implementation of the new Mental Health Strategy ensuring that it is recovery-focused, empowers service users and their families, and supports the Mental Health Measure by prescribing the services which individual Care and Treatment Plans demand.

• Take full advantage of the Mental Health Measure which promotes holistic care and treatment planning. The Seminar will look at the ways in which service users can take the lead in negotiating robust Care and Treatment Plans which address all areas of life.

• Ensure that the families and carers of people with a serious mental illness are able to exercise their rights under the new Carers' Measure and Mental Health Measure so that they can support the people they care for on their path to recovery - and achieve a better life themselves.

• Promote the take-up of other opportunities provided by the new Mental Health Measure for improved primary care services (including mental health assessments, short-term interventions and onward referral to secondary services), for an expanded scheme of independent mental health advocacy for all in-patients, and for improved and faster re-access rights for those who have been discharged from secondary services.

The “Movin’ On Up” Seminar, which is supported by Hafal with help from our friends in Bipolar UK and the Mental Health Foundation, takes place at the Media Resource Centre in Llandrindod Wells. The Seminar is mainly by invitation but there are a few additional places available – if you are interested, you can apply by completing a booking form and returning it to Emma Billings all via this link.

The Seminar is just one event in a summer-long itinerary of "Movin’ On Up" activities including: 22 weekly county events covering the whole of Wales; a Pen y Fan climb on 11 May; an interactive stand at the Royal Welsh Show in July; a Snowdon climb on 28 September; and a display at the National Assembly on World Mental Health Day in October.

Ancestors

Bit of a shock to see restaurant critic and foodie Giles Coren on BBC2 tonight claiming to be related to me. He was presenting the latest programme in the series "Our Food" and showed a copy of a photo which has pride of place on my living room wall showing four Ceredigion cattle dealers and their drover (on the left in his distinctive long coat) taking a drink together way back in the 19C.

Apparently Giles' Mrs is descended from one of them but he got it wrong saying that they were all drovers. In fact the four to the right (all cattle dealers and farmers) are brothers and the second from the right - looking rather shy and retiring like me - is my great, great grandfather, also like me the third of four brothers.

One of his grandsons (my grandfather) left to study theology at Lampeter (then an outpost of Oxford University) and took holy orders - and judiciously married the daughter of the Felinfoel Brewery. As a dashing curate in the early 20C he would roar past what is now my house on his Royal Enfield 425cc V-twin motorbike to visit his family near Llandysul.

You can see the show - almost as interesting as my ancestors - on this link.

Superstitious

I have drawn Seabass (odd name for a horse) in the Hafal Head Office Grand National Sweep. Having won last year I have high hopes and the form looks very encouraging at first glance. He has won his last six races and seems to be in fine condition. And odds of 14/1 are quite short for this race.

However, on closer inspection I see that he has never run close to this distance and never outside Ireland. Oh dear. There is some consolation in observing that he has the most charming jockey in the race, brilliant amateur Katie Walsh, though it is also a fact that a lady jockey has yet to win the National (because they aren't given the best horses).

But, hey, there has to be first time for everything. Apparently Seabass excels on heavy ground so next Saturday in Aintree Dissolve, thick cloud, and rain; that I may say,/The gods themselves do weep!



Postscript:

Spooky: the post which announced my National victory last year was entitled Bass Notes and featured a picture of a seabass (see here). If I was superstitious I'd be tempted to place an each way bet...

Critical Mass

A long weekend in Bristol, a bit of a favourite with me as you can see from previous posts on this Blog. On Good Friday I clock up 28,000 steps on the pedometer as we climb up to Clifton, cross Brunel's suspension bridge (scarily high above the Avon!) and back around the docks to the centre.

On Saturday I bump into a demo by local NHS staff with whom I have a good chat. They are worried about the new (English) Health Act, creeping privatisation, etc. This is another reminder of the frustration which those of us who believe in reform face as a consequence of the dog's breakfast which is this Act. It has probably set back real reform by a decade or more because of the suspicion it has raised in the public's mind about the UK Government's intentions. And it's the public's view that matters - I was never going to persuade the demonstrators in Bristol that there is a case for reform but the public could buy into reform (which actually has strong cross-party support though you may find it hard to believe after the furore over the Act) if it was thought through, explained properly, and piloted and tested rigorously.



My own prediction is that, without radical reform according real choice and control to patients, the principle of the state ensuring that quality health services are available to all will come under severe pressure. The middle classes will increasingly insure privately because they resent and don't trust the present "take-it-or-leave-it" and "when-we-get-round-to-you" system and then use their votes to beggar the NHS because they will have little or no personal stake in it.

The critical mass of privately insured citizens (who are much more likely to vote of course) could be reached quite quickly when prosperity returns and living standards start to rise again - assuming this ever happens of course!

And here's a snap of another of Brunel's engineering feats the SS Great Britain (top tip: you can get this close without paying the exorbitant entrance fee by peeking over the fence by the gift shop).

Falling Off A Cliff

Gwenda Thomas AM (left) flying the flag for Hafal

Very honest of Deputy Minister for Children and Social Services Gwenda Thomas AM to describe the transition from children's to adult services as "like falling off a cliff edge".

She was speaking last week (follow this link for more) about the potential impact of the Social Services (Wales) Bill on children and young people with a serious mental illness.

The Welsh Government asserts that the aim of the Bill is to give people who receive care a stronger voice and "real control" over the social care services they use. One of the biggest problems facing young people with a serious mental illness is the transition to adult mental health services.

The Deputy Minister said: "The Bill will provide freedom for people to maintain a level of continuity in their care when they move from location to location through the introduction of portable assessments. The Bill will also tackle the postcode lottery and improve consistency of services."

Meanwhile Dr Mike Shooter CBE, an old friend of Hafal and now Chair of Children in Wales, said: "I am optimistic. Wales was the first country in the UK to sign up to the United Nations Convention on the Rights of the Child and we have a rights-based government. We were the first country in the UK to have a Children's Commissioner, a Children's Minister and a Standing Committee on children's issues. We are the first country in the UK to have counselling services in all our schools. And I'm sure we can get this Bill right for young people too. It's why I'm proud to have lived and worked here for most of my life."

Mike isn't wrong about this. Since Devolution there has been a refreshing willingness to embrace progressive policy and legislation in Wales and not just in children's services: you can look back at the Welsh Code of Practice for the Mental Health Act and, right up to date, the Mental Health Measure and its Regulations - all quite in contrast to England where mental health legislation has been grudging and over-cautious.

But the jury is still definitely still out. It's delivery, delivery, and delivery we need to see now.

Hafal Abroad

Hafal's new office in Puerto Madryn

After many months of painstaking development work, often frustrated by linguistic and diplomatic obstacles, it is very gratifying to be able to announce today the opening of Hafal's new Regional Office in Puerto Madryn, our first development beyond Wales and truly an historic day for the charity.

Having secured our position in Wales, with substantive services in all 22 counties, it was logical for us to look elsewhere, and where more obvious than the most significant Welsh community abroad? The descendants of the famous Welsh immigration to southern Argentina (see this link for the history) retain strong ties and a common language on which we can build. Our new office in Puerto Madryn represents an important starting point but we have in mind a series of projects in other communities including Treliw and Trevelin.

Our new Regional Manager Estafania Jones-Pritchard comments (translated from our bilingual Spanish/Welsh press release): "We are really pleased to be joining the big family that is Hafal and look forward to working with our friends across the Atlantic Ocean. I had a valuable teleconference with Señor Walden-Jones yesterday and he says he will very shortly be opening discussions with the Ministry of Health in Buenos Aires in order to secure funding for our salaries and other overheads under the Sección Sesenta Cuatro Grant Scheme".

Of course there are logistical and communications challenges. We had hoped to do most contact by Skype but, if the experience of doing this with our North Wales office is anything to go by, then we will have to think again. In any case there is no substitute for dealing with matters in person. We have worked out that if Deputy Chief Executive Alun Thomas and, on alternate weeks, Company Secretary Nicola Thomas leave Hafal Head Office at 5pm on Friday they can catch the overnight Iberia flight from Heathrow to Rio Gallegos and, with two further hops on a local carrier with single prop planes (and a rock-solid 75% safety record), they can get to our new office in time for the 11am Monday morning management meeting. They understandably raised concerns about the hours involved but I was able to reassure them that from the moment they leave UK airspace the European Working Time Directive does not apply.

Exciting times and there is more to come. If we can keep to our Strategic Plan then this time in 2013 I will be announcing the opening of our new base in Brittany, the next logical extension for Hafal. In case you think this may stretch us too far then bear in mind that this is a comfortable 40 minute flight away and I have reassured Alun and Nicola that I will handle this one myself. I have already got some ideas for this and you can see my proposed work-base here.