What follows is a review of crumbs from the political table; to provide some ammunition to use when investigation of mistakes in mental health care hits a brick wall.
This article relies heavily on the words of Health Secretary Jeremy Hunt in his speech to the Conservative Party Conference on 4 October 2016.
He began by saying that he wanted the NHS ‘to offer the safest, highest quality care of any country in the world for you and your family’.
On mental health he admitted ‘for decades frankly it has been a second-class citizen in the NHS’. He noted some improvement in the number of mental health patients treated per day and in the diagnosis of certain psychiatric conditions but he made the point ‘we still need to do better’.
He promised treatment for 1 million more people a year by the end of the current parliament. He praised the work of mental health nurses and volunteers, who probably bear the brunt of provision of the service, and particularly acknowledged patients who fight stigma by speaking out about their conditions. He emphasised the provision in the Health and Social Care Act 2012 providing for ‘parity of esteem’ with other aspects of healthcare. The statutory provision is of course admirable but surely truly an unenforceable area of legislation.
Mr Hunt went on to talk about enquiries into poor care and said: “So let’s be clear, closing ranks against families who want to know the truth about their loved ones has no place in the NHS.”
He admitted that there were 150 avoidable deaths in the NHS every week.
He criticised the ‘blame culture’ that existed and that it was not a ‘learning culture’. He wanted to see dismantling of that culture and its replacement with one that supports improvement. But at the same time he referred to establishing ‘a safe space (for doctors) to speak freely about medical error’. If that takes a lead from the much-quoted airline industry risk management arrangements where the benefit to the industry generally takes precedence over the interests of a damaged individual, that surely can only mean less disclosure to the patient.
He reported being deeply moved by a failure of care by a community mental health team in Cumbria which led to a young girl’s suicide. He promised that the statutory ‘parity of esteem between physical and mental health (will lead to) an improved suicide prevention strategy in a safer NHS’.
Lastly he agreed and admitted that ‘safer care does not cost more, it costs less’. He follows that with a criticism of the cost of litigation but notes that litigation only happens when things go wrong.
There was much more said, not all of it positive and much of it unconstructively political. Not surprisingly other parts of the speech caused more excitement in the press.
Tim Wright, a senior associate in the clinical negligence team at Penningtons Manches LLP, commented: “The tenor of the quotes in this article is constructive change and many of the above can usefully be quoted to the health service when things go wrong and nothing is done to explain or correct the problem.”