Monday 2 June 2014

Scrutiny, Honesty, Probity

The RCP's posh new HQ in E1 - not as posh as the old address in Belgrave Square SW1 but no doubt more comfortable

This morning I was supposed to appear on Radio Wales to discuss the Royal College of Psychiatrists' survey announced in the news today - but at the last minute I was bounced by breaking news on Madeleine McCann and Qatar (I thought I had worked out that Qatar business years ago - see this post).

The survey found that cuts to mental health services in the UK are "approaching a tipping point". The survey, by RCP’s Psychiatric Trainees' Committee, asked junior doctors working in psychiatry across the UK to talk about their experiences of working in mental health over the last six months. A total of 3,504 trainees were contacted. Of the 576 trainees that responded: 70% said they had experienced difficulty finding an appropriate bed for a patient at least once. In child and adolescent services (CAMHS) that figure was 83%.

The survey includes Wales although the sample from Wales was quite small. Nevertheless, there are very similar problems in Wales to those in England.

There has been a longstanding suspicion that the Mental Health Act has been used inappropriately as a way of gaining access for patients to hospital and of course this becomes a more serious problem when there is poor availability of beds.

This is not just an unacceptable invasion of patients’ rights in a wider legal and ethical sense; it is also deeply anti-therapeutic, conveying the worst possible message to patients because it wrongly suggests that compulsion was necessary when in fact it was a fault in services.

The solution is also clear. We need sufficient beds – and that means having spare bed spaces to meet unpredictable demand; and we need scrutiny, honesty and probity in administering the Mental Health Act.