We are going backwards: mental health cuts exacerbate a growing health burden

We are deeply concerned by recent cuts to NHS mental health service providers which exacerbate the problems of an already extremely under-resourced sector.

These cuts are the most recent in a long list of events that display the Government’s lack of support for the sector, says Isabella Goldie, our Director of Development and Delivery: “Despite mental health problems being 23% of the burden of illness in England, funding (currently sitting at 13%) is becoming even more disproportionate.

“Whilst we absolutely welcome the government’s commitment to parity of esteem for mental health and a move to a focus on outcomes, recent figures show immediate and drastic action is needed”.

Figures from a recent HSJ analysis of all 57 Trusts show one in five experienced cuts of 5-9%, leading to a dramatic reduction in beds and staff available to people who require acute mental health support.

“We can see from the steep rise in out-of-area placements that those who need highly specialised care and support are travelling long distances for services.

“It is unacceptable that people, at their most vulnerable, afraid and distressed, are being placed in unfamiliar areas, and shows that mental health services are reaching a crisis point.

“Given that 1 in 4 people (and growing) will experience mental health problems this is an issue that affects us all.”

We advocate for more work to be done in prevention across the course of a life and call for further investment in evidence-based preventative approaches such as parenting support.

“Any compassionate society needs to ensure that our public services are available and fit for purpose when people are at their most vulnerable,” says Isabella.

“For mental health services this means ensuring services are measured and funded based on outcomes that drive real improvements to the lives of people with mental health problems.”

Our joint Mental Health Policy Group has joined a wide range of other professional bodies, service user and carer groups and academics to express concern about what this means for already disproportionately funded mental services and the aim of the government to create parity of esteem.

Via http://mentalhealth.org.uk/

Advertisements

The divisive language that drains support for those on benefits

Further to your coverage of the sad and wasteful death of David Clapson (‘No one should die penniless and alone’, G2, 4 August), today (9 August) marks the anniversary of the discovery of the emaciated body of Mark Wood, a vulnerable sufferer from severe mental health problems, in David Cameron’s Oxfordshire constituency. Mr Wood had been erroneously and incompetently declared fit for work by Atos (on behalf of the DWP) and the consequent cutting of benefits was a clear “accelerating factor” in his death by starvation. The architects of deaths like these remain in charge of the DWP. There have of course been other well-attested deaths-by-DWP and there will be more (especially among the vulnerable disabled), as current reforms roll out their panoply of delays, despair and effective victimisation across the country. The real human costs of sick government must never be forgotten.
Stewart Eames
Cambridge

• David Clapson’s death is a sad reflection on the impact of government policies. I was fortunate enough to be able to work from the age of 15 to 70, paying all due taxes. Should we really care if a few people manipulate the system, if it means that no one is unfairly penalised and slips below the safety net necessary to provide a reasonable standard of living? I am not religious, but I do think that this heartless government should consider “there, but for the grace of God, go I”.
Wendy Collins
Batley, West Yorkshire

• The harrowing comments on benefit sanctions (G2, 6 August) didn’t discuss the political basis for these punitive measures. People mostly vote on a tribal basis, for “our sort of people”. When people become afraid of falling into poverty they take comfort in the hope that it only happens to the “other sort of people” and vote Conservative as an act of faith. This is the same mechanism that unites a country under threat of war and persuades dirt-poor Americans to oppose Obamacare rather than admit to themselves that they might one day need it.
D Sewell
Driffield, East Yorkshire

• Shame on the Guardian for describing out-of-work benefit recipients as “the idle poor” (Report, 5 August). On the basis of what evidence do you write them off as idle? Are those caring for children or infirm relatives, volunteering in the community, actively seeking work or simply working hard just to get by on a low income idle? Language matters and it is the use of othering language such as this by the media and politicians that has contributed to the “draining away of public support” for social security.
Ruth Lister
Labour, House of Lords

Via http://www.theguardian.com/


The UK’s mental health care is in crisis – the next government must act urgently

Mentally ill patients forced to travel hundreds of miles for treatment, forcible sectioning in order to get beds and medical students begging for greater teaching on psychiatry: we’re not getting it right

Just last week, data obtained from freedom of information requests led to claims that the NHS treated mental health care as a “second-class service”. Indeed, thousands of mentally ill patients have been forced to travel “hundreds of miles” for treatment in recent years. Extreme cases have seen patients being forcibly sectioned so that they can receive care in overcrowded wards. Even medical students have resorted to asking for greater teaching on psychiatry, highlighting the derisory attention that mental health issues receive. Yet the state of mental health services is unsurprising considering that they receive only 13 per cent of the NHS budget, despite mental illness affecting around a quarter of the UK population.

Worse still, national spending on mental health has consistently decreased over the past three years. And the trend isn’t limited to adult care; mental health services for children and adolescents have also seen a fall in funding. This decline seems even more irrational considering adolescence is the period when many mental illnesses first manifest, and that hospitals are recording a rise in hospital admissions for conditions such as eating disorders.

The budget cuts have had a noticeable impact, with doctors citing the changes as a cause of “avoidable deaths and suicides,” while mental health organisations claimed that the cuts “put lives at risk”. Mental illness also has a significant impact on a patient’s quality of life, and is thought to contribute to poor physical health, having been associated with diabetes, cancer and cardiovascular disease. As well as the ethical concerns of these cases, such neglect of the mentally ill also has practical implications; a report by the London School of Economics found that the NHS could save over £50m a year by reversing budget cuts to preventative and early intervention therapies.

Yet perhaps the most striking aspect of the decrease in funding comes from the comparison with other areas of health care. The government, for instance, took great pride in announcing that the Cancer Drugs Fund would be ring-fenced until 2016. While it would be wrong to question the severity of diseases such as cancer, it is worth considering that this budget is reserved for treatments that aren’t ordinarily commissioned because they are not cost-effective. Given the nature of the NHS’s funding crisis, it seems unfair to fund relatively inefficient treatments, while the NHS’s most vulnerable patients are left without basic care.

This is the problem. Eager to brand their “reform” of the NHS as good for patients, the coalition has protected the emotive areas of health care that already benefit from public awareness. Aware that severely cutting the budget for paediatrics or cancer care would result in public outrage, the government are cynically withdrawing care from those most lacking a voice in society: the mentally ill.

Although this current crisis is alarming, such disregard of mental health isn’t a recent phenomenon. Plagued by a history of taboo and prejudice, mental health care has historically been chronically underfunded. With a media happy to brand mentally ill people as “psychos” and a threat to society, it has been relatively easy for politicians to excuse this injustice. But public perceptions are changing; a report by the charity Rethink Mental Illness found that public understanding and tolerance of mentally ill people is improving, while 63 per cent were aware of a close friend having a mental health problem.

This is important; for a politician to stand up for mental health care now wouldn’t just be a principled action, it’d be a popular one. With time, and the excellent work of campaign groups, this positive trend in public attitudes will only continue, allowing society to grow in confidence to discuss one of our greatest health challenges. The mental health charity Mind suggests that the next government commits to a 10 per cent rise in the NHS’s mental health budget over the next five years. Considering the state of mental health care and the current funding disparity between health services, this is not an unreasonable request.

Past governments have chosen an area of health care to focus on, in order to target voter demographics. In 1999, Blair announced his “crusade against cancer”. Seeking the “grey vote”, David Cameron called for a “national challenge” to beat neurological diseases such as dementia. But the disgrace of the NHS’s mental health provision goes beyond party politics. Regardless of who wins the general election, the next government must embrace bold reform to end our longstanding neglect of the mentally ill.

Via http://www.newstatesman.com


Police boss blames welfare reforms for 35% increase in shoplifting claiming cuts victims are ‘stealing to survive’

A POLICE commissioner has blamed the Government’s welfare reforms for a 35 per cent jump in shoplifting, claiming thieves are “stealing to live”.

Ron Hogg, Labour Police and Crime Commissioner (PCC) for Durham, said usually law-abiding people were turning to crime because they were unable to feed themselves – and blamed the Coalition’s benefit changes, including the so-called bedroom tax.

Mr Hogg admitted there was no evidence of a direct link but said: “Shoplifting is up 35 per cent year on year and an awful lot of people are stealing to live.”

He added: “We predicted this tax would cause massive problems for some of the most vulnerable in our society.

“With more welfare reform yet to be implemented the situation will only get worse.”

Mr Hogg’s claims were supported by Barry Coppinger, Labour PCC for Cleveland, where there has been a 7.3 per cent rise in shoplifting.

He said: “Deep and relentless welfare reforms have a knock-on effect on other crimes, particularly shoplifting, as families turn to the black market to buy food and other items they can’t afford in the shops.”

The Conservative Party referred enquiries to the Home Office, which said it was a matter for the Department for Work and Pensions (DWP), where a spokesman said there was absolutely no evidence linking welfare reforms to increased crime.

He said the reforms were guaranteeing a strong welfare net and £345m had been given to councils to help the most vulnerable.

“Ending the spare room subsidy was absolutely necessary in order to get the soaring housing benefit bill under control, returning fairness to the system and making better use of social housing stock.

“These rules already applied to the housing benefit claimants in the private sector – introduced by the previous Government.”

Rebecca Coulson, the prospective Tory parliamentary candidate for Durham City, said: “It’s never sensible to make excuses for criminal behaviour, or to imply that shoplifting is acceptable.

“We all still live in straitened times, following the recession, but the Conservative long term economic plan is working.”

A recent DWP report found 522,905 households were affected by the so-called bedroom tax by last August and nearly a fifth of claimants had registered an interest in downsizing.

More than half of claimants had cut back on household essentials, a quarter had borrowed money and three per cent had taken pay day loans.

Mr Hogg and Mr Coppinger advised people to use credit unions.

In Durham, about 100 female shoplifters have avoided being charged by sitting a life issues course.

Via Welfare News Service via  http://www.thenorthernecho.co.uk/news/11393471.Police_boss_blames_welfare_reforms_for_35__increase_in_shoplifting_claiming_cuts_victims_are__stealing_to_survive_/?ref=twtrec

 

 

 

 

 


Benefit sanctions hit most vulnerable people the hardest, report says

Claimants not told about hardship system and sanctions imposed when they were not at fault, DWP study finds

Many jobcentre advisers identified a ‘vulnerable’ group who tended to be sanctioned more than others, the report said.

Systematic problems in the way the government administers and imposes benefit sanctions, including disproportionate burdens on the most vulnerable, are revealed in a report commissioned by the Department for Work and Pensions.

The report found the way in which the DWP communicated with claimants was legalistic, unclear and confusing. The most vulnerable claimants were often left at a loss as to why benefits were stopped and frequently not informed by the DWP about hardship payments to which they were entitled, it said.

It also revealed serious flaws in how sanctions were imposed, with Work Programme providers required to send participants for sanctions when they knew they had done nothing wrong, leaving “claimants … sent from pillar to post”.

The independent report was written for the DWP by Matthew Oakley, a respected welfare expert who has worked as an economic adviser for the Treasury and for the centre-right thinktank Policy Exchange.

He is widely acknowledged as one of the leading thinkers on welfare on the centre right and as a result his criticisms, couched in careful language, are all the more damaging for a government that has consistently said the sanction regime is fair.

The DWP responded to the report by saying it would be updating the way it talked to benefit claimants, setting up a specialist team to look at all communications, including claimant letters, and working more closely with local authorities and advice centres to simplify the system.

The government will also streamline “the robust checks and and balances that are already in place that give claimants the opportunity to provide evidence why they have not complied with the rules”.

It will also clarify the guidance on how claimants can access hardship payments, as well as co-operate more closely with Work Programme providers so there is more integration about what a claimant is permitted to do without facing the threat of a benefit sanction.

Oakley’s report said: “No matter what system of social security is in place, if it is communicated poorly, if claimants do not understand the system and their responsibilities and if they are not empowered to challenge decisions they believe to be incorrect and seek redress, then it will not fulfil its purpose. It will be neither fair nor effective.”

Although Oakley said the regime was not fundamentally broken, he made 17 recommendations for reform.

His terms of reference confined him to the way in which sanctions are administered on mandatory back-to-work schemes, which cover a third of those claimants at risk of being sanctioned, but he said his proposed reforms were relevant to the entire benefits system.

The report said “letters were, on the whole, found to be complex and difficult to understand. Partly as a result of the legal requirements the department has to fulfil when it writes to claimants, regular concerns were that letters:

• Were overly long and legalistic in their tone and content;

• Lacked personalised explanations of the reason for sanction referrals;

• Were not always clear around the possibility of and process surrounding appeals or application for hardship payments; and

• Were particularly difficult for the most vulnerable claimants to understand – meaning that the people potentially most in need of the hardship system were the least likely to be able to access it.”

The report added: “Actual and sample letters that the review team saw were hard to understand (even for those working in the area), unclear as to why someone was being sanctioned and confusingly laid out.”

The review found that many people “expressed concerns that the first that claimants knew of adverse decisions was when they tried to get their benefit payment out of a cash point but could not”.

The report also said jobcentre advisers had highlighted the damage sanctions imposed on the most vulnerable. It stated: “Many advisers also highlighted the difficulties of communicating with particular groups of claimants. In particular, many advisers identified a ‘vulnerable’ group who tended to be sanctioned more than the others because they struggled to navigate the system. This concern for the vulnerable claimants was consistent throughout the visits.

“For these groups, particular difficulties were highlighted around the length of time it could take to ensure some claimants fully understood what was required of them and in conveying that a ‘sanction’ could entail the loss of benefit for a prolonged period of time.”

The report also criticised the failure of the jobcentre to highlight hardship payments. It said: “A more specific concern surrounding the hardship system was that only those claimants that asked about help in Jobcentre Plus were told about the hardship system. Advisers, decision makers and advocate groups argued that this means that groups with poorer understanding of the system are less likely to gain access.

“Since, on the whole, more vulnerable claimants are those with the poorest understanding of the system, this suggests that some of those most in need are also those least able to access hardship.”

The report also found that providers of mandatory work schemes were unable to make legal decisions regarding good reasons for missing appointments and so had to impose sanctions.

“This means that they have to refer all claimants who fail to attend a mandatory interview to a decision maker even if the claimant has provided them with what would ordinarily count as good reason in Jobcentre Plus. This situation results in confusion as the claimant does not understand why they are being referred for a sanction.

“A very high proportion of referrals for sanctions from mandatory back-to-work schemes are subsequently cancelled or judged to be non-adverse.”

A lack of coordination between the jobcentre and Work Programme can “result in a situation where claimants are passed from pillar to post, without either Jobcentre Plus or providers taking responsibility for explaining the claimant’s situation. More commonly, we heard that Jobcentre Plus advisers had to spend large amounts of time dealing with claimants’ queries about sanctions from mandatory schemes.”

Poor understanding of the good reason process mean claimants subsequently appeal a sanction and often win, at cost to the DWP and taxpayer.

A key reason the report found for the confusion was that, because different organisations use different IT systems, neither providers nor Jobcentre Plus hold all the information needed about a claimant’s current experience and potential sanctions.

Via welfare news service via http://www.theguardian.com/society/2014/jul/22/benefit-sanctions-vulnerable-people-hardship-dwp-report


DWP awards Atos £10 million IT contract for healthcare assessments

Atos to continue providing IT for controversial work capability tests despite paying to exit contract early

Atos is due to exit its controversial DWP contract for health and disability assessments by February next year, instead of the original end date in August.

The French multinational has come under fire for the number of work capability decisions that have been overturned and the firm recorded roughly 163 incidents of abuse or assault on staff in 2013.

The firm announced its intention to walk away from the contract in February and the government confirmed that Atos would exit the agreement early in March.

However this new contract means the firm will continue to provide the IT for the assessments until at least 2016, with allowances for it to be extended until 2020.

The contract, which the DWP described as an ‘interim arrangement’, was negotiated and set up without any competition.

The department said that this was for ‘technical reasons’, some of which were set out in the award notice, which was published in the Official Journal of the European Union (OJEU) at the end of last week.

The DWP said that an alternative provider would not be able to set up the new services in time without there being “an unacceptable level of service transition and delivery risk failure”.

In the OJEU notice, the department also claimed: “Another supplier would be unable to provide the IT services using the existing hardware, software, premises, etc, because the physical assets are owned by the current provider of the assessment services rather than the Authority.”

The DWP said: “Another supplier would be unable to replicate the current IT services because there is insufficient documentation to build them.”

It also said that another supplier wouldn’t be able to replace the physical assetes on a like-for-like basis because some of the assets were out-of-date and now unavailable.

The DWP told ComputerworldUK that although a new provider is expected to take over the contract next year, the IT will be transferred separately and at a later date.

A spokesperson said: “The DWP is seeking a new provider to help increase the volume of assessments carried out and improve the claimant experience, in particular looking to reduce waiting times and modernise delivery, including looking to replace the current IT.

“To make sure claimants get a good service during transformation, we are transferring the IT separately, and at a later date, than the rest of the service [which transfers in 2015].

“We have therefore asked Atos to continue to provide the current IT services for a further year. In the meantime work has started on planning for how we replace the IT.”

In a statement to Parliament in March, disability minister Mike Penning MP said that Atos had paid the department to terminate its contract early.

He said: “I am pleased to confirm that Atos will not receive a single penny of compensation from the taxpayer for the early termination of their contract, quite the contrary, I can also confirm that Atos has made a substantial financial settlement to the Department for Work and Pensions.”

However the DWP refused to disclose the figure paid by Atos when contacted by ComputerworldUK.

The contract for healthcare assessments between the DWP and Atos was awarded in 1998. It was renewed for seven years in 2005 and then extended for a further three in 2010 through to 2015.


ATOS, DEATHS AND WELFARE CUTS

Was it public outrage or the impossible task that made Atos want to stop? Adam Forrest investigates

Some paperwork is almost unbearable. Sitting in the living room of his Essex home, Peter Wootton sifts through his wife Linda’s files with a sigh, pointing out where an Atos assessor judged her fit to work in January 2013.Linda could lift a mobile phone. Linda could rise. Linda could walk across the testing room. So Linda was fit to work. “The test only took 20 minutes,” Peter remembers. “She was crying for longer than that beforehand. I’ll keep these documents forever, no matter how painful they are.”Linda (pictured below), a double heart and lung transplant patient, died on April 25 last year. Only nine days before, the Department of Work and Pensions (DWP) finally rejected her claim of employment support allowance (ESA) of £108.05 a week, sending her a curt letter while she lay desperately ill in hospital.

She had scored zero points on her Atos test. In her final months Linda was on 10 prescription drugs a day, suffering high blood pressure, renal failure and regular blackouts.
“The benefits were actually stopped on February 14,” Peter explains. “Happy Valentine’s. She was in hospital with a chest infection, typing her appeal on her iPad, crying her eyes out. We were lucky because I earned a salary that meant we were OK and we didn’t lose the house.

“But she felt distraught about it. She’d say to me, ‘I’ll have to go back to work then.’ It was only in the days before her death she said, ‘Well, maybe I wasn’t fit for work.’ Only when she had been told she was going to die.

“The thing I find so galling is that at no point did they speak to the doctor who said her condition would not get better back in 2007,” he continues. “At no point did they speak to anyone at Harefield Hospital where she’d had her transplant. Why wouldn’t they do that?

“When you lose your wife… no one can describe it. The desolation is beyond words. I’m doing better than I was last year but the grieving process goes on forever. People say it gets better with time – it doesn’t. I’ll carry on missing her.

“I’m not blaming Atos for her death. She died because of a collapsed lung and blood clots after a medical procedure. But I pitied the way Linda was made to feel and I still feel very, very frustrated at the way she was treated.”

To say Atos’ reputation has been damaged by the work capability assessments it has carried out for the UK government is an understatement. A day of national demonstration in February saw angrycampaigners at each and every one of Atos’ 144 offices across the country.

At each anti-Atos protest, the names of the dead are listed and held on cardboard squares, a grim liturgy to people who have passed away while undergoing the reassessment process. “ATOS KILLS” is the most familiar shout and placard slogan.

The company is trying to find a way of bringing the DWP contract to an early end without looking “unprofessional”The French IT firm says around 160 incidents of the public assaulting or abusing staff were recorded each month last year (most of the anger is vented on social media where Atos employees are referred to as “murdering scumbags”). Little wonder the company is trying to find a way of bringing the DWP contract to an early end without looking “unprofessional”.

As Atos itself admits: “In its current form it is not working for claimants, for DWP or for Atos Healthcare. For several months now we have been endeavouring to agree an early exit from the contract, which is due to expire in August 2015. Despite these ongoing discussions, we will not walk away from a frontline service.”

As all current Employment and Support Allowance benefit claimants are given short-term respite from further tests (reassessments are on hold for “an indefinite period”, according to a leaked DWP memo), it is worth taking stock of the mess.

How bad a job have Atos assessors really made of it? How much is Iain Duncan Smith’s department to blame? And how much truth is behind claims the tests are responsible for the deaths of the disabled?

Government statistics indicate that between January 2011 and November 2011, 10,600 sick and disabled people died within six weeks of their benefit claim ending. Such was the furore about this figure, the DWP has stopped using Atos data to count the number of deaths.

If anyone wishes to Google “Atos”, “death” and “coroner”, they’ll find dozens of news stories about benefit cuts and suicides in the last couple of years, including many cases of people killing themselves after Atos assessments found them fit to work.

Take Tim Salter, a blind 53-year-old suffering from agoraphobia. Tim hanged himself after an Atos test that found him fit to work and a DWP decision to axe his £30-a-week incapacity benefit left him wondering how he could afford his housing association rent. South Staffordshire coroner Andrew Haigh declared: “A major factor in his death was that his benefits had been greatly reduced leaving him almost destitute.”

Take Edward Jacques, a 47-year-old man suffering from HIV, hepatitis C and with a history of self-harm and depression, who took an overdose in September after his £90-a-week benefits were stopped. Nottinghamshire coroner Mairin Casey said Edward’s medical assessments had been “crude”.

She found that “the process in Edward’s case did not fully or properly reflect Edward’s physical and mental health at that time. It is desperately sad that such evidence was not available either to the nurse or to the decision-maker.”

One of the very saddest deaths is David Coupe (pictured below), a former farmer in Derbyshire who died of a rare form of cancer in October last year. He had been stripped of his £50-a-week incapacity benefit and ruled fit to work in December 2012, despite being housebound with a painful back injury, ulcers and diabetes. It left David and his wife Lyn with just £71 a week for the last 10 months of his life.

“David got a very rare form of cancer, it took his sight and his hearing, then finally his life,” says Lyn. “But months before that Atos had taken away his dignity. His doctors and specialist nurses wrote to the firm but never received a reply.”

Lyn says she has now been sent a letter confirming David’s backdated incapacity benefit will be paid. The Labour MP Dennis Skinner brought up David Coupe’s case in the House of Commons, memorably describing Atos as a “heartless monster”. The Prime Minister conceded it was all “desperately sad” and used it to criticise the “quality of decision-making”.

This questioning of quality has helped lead to the fall-out between the government and Atos, which now realises a fresh start is in both parties’ interest. Yet many of the disabled campaigners have questioned whether the government can credibly claim any detachment from the process.

In May 2013, whistleblower Dr Greg Wood, a former Atos employee, revealed how skewed the tests were against claimants and how much pressure testers were under to change reports and find the right conclusion (ie: fit to work).

The contract was designed on the basis of reducing the number of claimsKaliya Franklin, aka Bendy Girl, who writes the Benefit Scrounging Scum blog, believes Atos has provided a convenient smokescreen for government strategy. “The contract was designed on the basis of reducing the number of claims,” she says. “Atos did what they were told.

“My fear is that the DWP will now be able to say they’ve listened, they’ve fixed something by getting rid of Atos, and then they will carry on limiting the number of claims in the way they set out to do. So whoever [a new contract] goes to, the system is designed not to bear any relationship with the real problems people face.”

Dennis Skinner says he isn’t sure “whether [Atos] are leaving before they’re shoved, or the government has realised it’s an opportunity to get rid of them and blame it on them”. The MP wants fundamental changes in medical testing of benefit claimants.

“People deserve representation when these decisions are made,” he says. “I would have a panel deciding things with someone from the local unemployed workers centre or Citizens Advice Bureau. And we need to have proper doctors who are medically capable.”

Back in Essex, Peter Wootton is watching the Atos era unravel with great interest. It is too late for his wife Linda to be treated with due consideration and dignity. But he hopes no one else has to suffer the same kind of misery. “Whether it’s been the DWP driving the whole thing or Atos organising the tests this way for financial gain, we don’t know,” he says.

“But we’re about to see with whoever does the tests next whether the government is only interested in numbers, rather than people. If nothing changes, it will point the finger squarely at Mr Cameron’s government.”

Via http://www.bigissue.com/features/3637/atos-deaths-and-welfare-cuts