Tuesday 23 October 2012

Wiggle Room

Yesterday I attended the launch of the Welsh Government's new mental health Strategy "Together for Mental Health" in Ystrad Mynach - see a summary and links to the document here. There isn't a lot to quarrel with in it. Indeed the Government has commendably listened to what Hafal (meaning patients and families) has said. A year ago I was concerned that the Government might not follow through the logic of the Mental Health Measure in its new Strategy but, in fairness, they have got that mostly right, in particular using the eight holistic "life areas" pioneered by Hafal over the last ten years to set out methodically what different agencies need to do to support patients' recovery.

A new feature of the Strategy is that it spends a lot of time looking at the wider issues of public health and public attitudes. What is said about these issues is fair enough but you could form the impression reading the Strategy that significant resources were to be expended on those wider matters whereas in reality the entire Government expenditure on such things would pay for little more than one specialist in-patient bed. But then the Government has got that right: there isn't any new money and if there was we would be arguing that it should be spent on direct services for those most in need.

The least sexy but most important part of the whole Strategy is the undertaking to continue (and test the functioning of) the ring-fence around NHS mental health spending. Nothing will improve if the "floor not ceiling" (as the Minister described it on the telly) of a minimum level of NHS funding for mental health is not maintained as the squeeze on public expenditure tightens in the next couple of years. But at present there is a suspicion that the significant "discretion" which Directors of Finance in the LHBs have about how they allocate costs may well mean that the ring-fence is not all it's cracked up to be. We urgently need to shed light on the detail of mental health costs in the LHBs so that there is no wiggle room.

Meanwhile there was extensive coverage in the media of Hafal's clients and staff commenting on the launch, including me peering over my £10 Tesco glasses in a manner which drives my younger brother potty with irritation. I thought it looked rather authoritative.


"Wiggle room" is correct, not the increasingly common "wriggle room" (notwithstanding its pleasing alliteration).