Ponty Party

The “Taking the Wheel” campaign reached Pontypool yesterday.

Hafal's Torfaen Practice Leader Pam Johnson reports: "Our theme for the day was 'Looking after yourself physically'. We chose this theme because recovery from serious mental illness isn't just about medication or other therapies that deal directly with symptoms. These can be very important but mental health is built on much broader foundations and we wanted to emphasise the importance of physical health in relation to recovery."

Exercise and therapy sessions took place during the event and a buffet was provided. Carers, service users and key contacts in mental health services attended along with local school children.

Pam added: “Service users have been talking about the new legislation in Wales; they welcome the Mental Health Measure and hope that the new law will improve the quality of care plans.”

Pam also raised a priority concern in Torfaen: “Service users value the services which Hafal provides particularly the support we give families affected by serious mental illness. Clients would like our family support and advocacy service to be expanded as Hafal can only provide 10 hours a week at present due to lack of funding. This service has to cover the whole borough; to be honest it only scratches the surface at the moment." A useful reminder that bread and butter issues concerning essential local services need to be addressed.

NHS Cuts...and Opportunities

Health economists indicate that Wales will suffer the biggest real-terms cut in NHS spending compared with England, Scotland, and Northern Ireland (see the story here).

A freeze in cash spending obviously does mean an effective "cut" because of inflation but we need to watch out for NHS Health Boards trying to impose cash cuts in mental health services which actually means they would be being picked on more than other services. That is not to say that savings cannot be made in mental health services but these need to made intelligently and the savings used to fund gaps in mental health services - that's what the promised ring fence means or else it means nothing.

Hafal has pointed to two distinct areas where savings could be made:

(1) "Repatriation" of high-needs patients from expensive and untherapeutic placements out-of-county or even out-of-country where this is in the best interest of the individual patient.

(2) Rationalisation of mental health teams working within the community. This would require reform of the traditional CMHT functions and approach: instead of addressing problems planners and commissioners have "worked around" the CMHTs by setting up new teams, some very good but we need their modern approach to become the mainstream in a joined-up team.

In addition medium-to-long term there is a clear opportunity to rationalise commissioning of all secondary mental health services (80% of spending on mental health) through systematic analysis of the new, universal, individual Care and Treatment Plans required from next January under the Mental Health Measure. A wise LHB Director of Finance (and their Social Services equivalent) will see these Plans not as an additional expense but rather as a focused and efficient requirement for all expenditure on secondary services. In other words if it's not in somebody's Care Plan why are we paying for it?

In this they will have the support of patients who want spending to follow their individual needs, not to be told what's available and take it or leave it.

If LHBs and local government don't see the great opportunities presented by the coming of the new individual Plans for effective commissioning and spending then patients will need to tell them...

Hanging and Flogging

It is interesting that populist politicians in the two largest parties in Parliament are falling over each other to prove which is "tougher" on crime - or, put another way, who can polish their "hanging and flogging" credentials sufficiently to gain respect from the Sun's editorial team.

Justice Secretary Ken Clarke is the exception as he argues that he will continue to consider logically how crime can be reduced by reducing reoffending which is not necessarily achieved by banging people up more often and for longer spells.

It was assumed by the media and some hard-line politicians of all parties that his ill-chosen words on rape might finish him. But it is not that simple as the public too may have a more sophisticated view of these matters as witnessed by Question Time (see the story here). Nevertheless Clarke remains on shaky ground not because of the remarks on rape but because he is out of line with the prevailing attitudes to criminal justice of the old guard in both parties.

The significance of Clarke's tenure for people with a mental illness cannot be underestimated. He is the first Justice Minister to acknowledge unambiguously the pointlessness and inhumanity of imprisoning so many people with a mental illness and, though the jury is out on whether he can actually change things, his replacement with one of those "short, sharp, shock" populists could be a grave set-back.

During the Thatcher years when I worked for NACRO I met two Home Secretaries (when that brief also managed justice) of widely differing perspectives - patrician, liberal old Etonian Douglas Hurd and Llanelli-born Michael "Prison Works" Howard. But the fact was that there wasn't much difference in outcomes between these two any more than between Tory and Labour Ministers. Have things changed? Clarke probably offers the best hope in this Government but I think he won't survive long enough.



Postscript:

In case the above would lead you to believe that Llanelli only breeds hard-liners contrast the actions of my great, great, great, grandfather (and incidentally the father of the founder of the Felinfoel Brewery) David John, whose best friend was hanged and gibbeted for sheep-stealing in the early 19th Century. Contrary to law and at significant personal risk David cut him down at dead of night and gave him a decent burial. I'm not sure if the authorities ever caught him so please keep it to yourselves.

We too should find dignified ways to challenge the barbarity of today's system which incarcerates people with extreme psychotic symptoms causing them unspeakable distress.

It Asda Be Asda

"Taking the Wheel" reached Newport yesterday to be greeted by a good crowd of Hafal Members, campaign partners and many other visitors in Asda car park - a well-chosen venue as this is veritably the modern equivalent of a public forum in urban Wales.

Hafal's Newport Practice Leader Pam Johnson said: "Our popular campaign camper van and racing simulator have been on hand for visitors to view and enjoy; visitors have been able literally to ‘take the wheel' and race in the camper van simulator which has been a lot of fun. There's been plenty of information on serious mental illness available for people to take away, too."

Pam says the message from service users that has come out of the event relates to service planning by clients both on a local and national level: "Service users run our services in Newport and today's event has been a fantastic opportunity to celebrate that and talk about the ways clients can have greater influence in the planning and delivery of mental health services in the county. On a national level, our clients are also keen to get the most from the Mental Health (Wales) Measure - the first mental health law to be passed in Wales since the tenth century - which means there's been plenty to discuss today."

More about the campaign here.

We've Won the Lottery!

Fantastic news that Hafal has been awarded £199,907 from the Big Lottery. The money will be spent on supporting our new Tŷ Adferiad Centre in Porthmadog to provide a unique service to people with serious mental illness from all parts of Wales, giving them an opportunity to step back from their lives, review their recovery goals and take part in motivational activities.

The grant means that people from across Wales will have the opportunity to spend a few days in a beautiful part of the country where their time will be split between developing their plans for recovery and getting out to undertake challenging activities in Snowdonia and the Llyn Peninsula.

This is right "on mission" for Hafal, fulfilling a particular ambition of our Trustees to extend the opportunity to make use of our recovery programme to many more people. The Centre's doors will open at exactly the right time - as the new Measure comes into force from next year we will be able to support people with a serious mental illness to get maximum value out of their new legal right to a care and treatment plan.

The project was developed through listening carefully to patients who flagged up the value of getting away from the distraction of day-to-day routines in order to take a good look at life plans and sort out how to move forward with the right balance of ambition and realism. Hmm: I think I'll book my place now...


Postscript:

Talking of life plans I'm doing a lot of reading at the moment as my cough keeps me up at night. I recommend The Complete Essays of Michel de Montaigne which, though dating from the 16th C, are earthy, modern, and often very funny. They are also immensely soothing as he explores practical ways to get through life which allow for weakness and irresolution and (most untypical for a French philosopher) he doesn't claim to have all the answers.

Hands-on, Top-down, Kick-ass?

Congratulations to the new Welsh Government for calling itself the "Welsh Government" (and presumably a spade a "spade"). I remember old Rhodri Morgan introducing the "WAG" name (itself an improvement on pretending the National Assembly was running the country) saying that it was what the person in the street called it. Perhaps some did but on that argument you might equally have called it the "TBC" ("Them B*ggers in Cardiff" as I have heard it very consistently referred to ever since devolution, not necessarily with hostility, in the saloon bars of rural Carmarthenshire).

At least we never copied the original wording (long gone) used by our sister entity up north. "Scottish Executive" sounded like a brand name for a brief-case, hotel room, or possibly a euphemism for some kind of discreet "personal service".

Anyway, a warm welcome to the new Ministers including Lesley Griffiths at Health. Lesley used to work in the NHS and has also been a good supporter of Hafal in her Wrexham constituency. Arguably she has the toughest brief in the new Government as the successor to Edwina Hart's hands-on, top-down, kick-ass approach and the management structure of the Welsh NHS which demands a Minister prepared to roll her sleeves up and beat up on the senior execs and non-execs in the NHS relentlessly in order to make things happen.


Postscript:

Talking of Scotland there has been much referencing of Scottish national heroes since canny streetfighter Alex Salmond scooped the polls up there, among them William "Braveheart" Wallace. Sorry to be predictable but, you've guessed it, Wallace was actually Welsh. "Wallace" is just another spelling of "Welsh" and, more than that, his stamping ground is where the original British/Brythonic (ie Welsh) people got squeezed between the Anglo-saxons to the south and Picts and such-like to the north. Indeed Welsh was spoken up there for hundreds of years, possibly up to the Wallace's own time. Not for the first time the Welsh also featured in large numbers on the "English" side too, Welsh longbowmen being the "Special Forces" of those days. "Yr Alban am byth!" as Mel meant to say...

Moaning Minnie

I'm feeling pretty sorry for myself being assailed with health problems which you are just going to have to hear about (sorry!) or this Blog wouldn't be true to life.

I mentioned previously the tooth falling out and my amateur repair. This has now been replaced with a (still temporary) job and the dentist will install the permanent solution a week tomorrow - so the end is in sight but meanwhile my mouth has an alien presence in it which, inevitably, my tongue dances over obsessively.

Meanwhile I've developed first a sore throat and now a chest infection which necessitated me sleeping (not very well) sitting bolt upright last night because if I lay down it caused paroxysms of painful coughing.

As well as all that I had a glaucoma scare but that at any rate was put to bed yesterday when the specialist in Carmarthen gave me the all clear. Incidentally even if you haven't got sight problems get your eyes tested to check for this and other serious nasties. Top tip: eye tests are free in Tesco for anybody and if you need glasses they have a decent range at £10 including the prescription lenses. The Tesco optician referred me on when he spotted a possible problem.

Reading that I realise that this is all small potatoes really but thanks for listening...


Postscript:

Relative immobility owing to the cough leaves me time to contemplate the news. This Blog has had an occasional but coincidental focus on the wives of dictators in the Middle East (see here and here). I have also performed an important service in outing closet Welsh people (Shakespeare, Oliver Cromwell, etc) and so I feel bound to mention somebody in the news fitting both categories, namely Mrs Mubarak who has been arrested this week for corruption along with her husband the ousted President.

Susanne Mubarak is indeed Welsh I can reveal - her family comes from Pontypridd. Apparently the main charge against Mrs M is that she was scheming for her son to succeed her husband in the family business - not an unusual ambition for a Valleys mam but the lucrative business in question was not a chip shop on Gelliwastad Road but, well, Egypt.