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Missed the Budget, saw why it mattered
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22 April 2009
As Alistair Darling was delivering the Budget, this Alastair was speaking at the opening of a new MIND resource centre in Hertford. Fair to say I had the easier job.
The date for the MIND event was set before the date of the Budget, and I was trying to think of the last time I didn't follow a Budget live. I was probably a student.
I will catch up on events, and there will be lots of time to debate the Budget, and lots of things to say in future blogs, but in the meantime I wanted to quote something one of the other speakers in Hertford said.
Henck van Bilsen is a consultant cognitive behaviour therapist who also leads a degree programme in CBT at the University of Hertfordshire. Dutch by birth, he is a big, burly man with a big smile and infectious enthusiasm, and a Johnny Halliday song as his mobile phone ringtone.
And he spoke of a 'revolution' taking place in mental health services in Britain. He said the government had taken a conscious decision - he called it historic - to invest in improved access for mental therapies. As a result, he said, without having to go through a GP, it would be possible for people to go straight to a new regional centre for psychological therapies, and hopefully get help.
It is the kind of thing which you never hear about on the TV, rarely read about in the papers, but it matters to a lot of people. And it was refreshing to hear someone being so passionate about a choice a government had made, and talking so eloquently about the benefits that would bring.
He said sometimes we talk of good mental health as though it is an automatic, that we all have a right to happiness and contentment and it should never be challenged. But just as you have to look after your teeth, he said, so you need to look after your mind.
And just as the body goes wrong, so does the mind. I made much the same point. One in four of us will have direct experience of mental illness, as I have. Yet still people find it hard to talk about it. When you see someone with a broken leg, you know how to react. When you hear someone has cancer, no matter how close they may be, no matter how scared you or they may be, we all understand the kind of things we need to say and do. But despite improvements, mental illness remains in many ways the last taboo, which in turn leads to discrimination and isolation, with many mentally ill people saying those feelings of discrimination and isolation are worse than the illness they suffer.
Someone at the meeting asked me how long I thought it would take for attitudes to change. I feel they are changing, and possibly faster than we know. I talked of the fight against racism in football. I read an interview at the weekend with a footballer who was Chelsea's first black player and who used to take vile abuse - from his own team's supporters - and who admitted some of his team-mates could not see what the problem was. Today, a mix of legislative, cultural and campaigning change means whereas before nobody dared challenge the racists, now nobody dares expose their racism in the first place.
I mentioned the film about gay rights campaigner Harvey Milk - a film brilliant for the way it captured the nature of the ups and downs of campaigning - and the fact that only a few years ago, you could not have imagined a Tory leader feeling he had to support Labour legislation on same sex civil partnerships. Exactly how and when the changes in attitudes came is impossible to pinpoint. But the change came.
Or take something like smoking - if you'd have said to me ten years ago that today there would be near universal acceptance that nobody should smoke in buses, trains, planes, offices - let alone pubs and restaurants - I would have dismissed it as woefully out of touch. But it happened. Change happens.
It may be optimism generated by meeting Henck van Bilsen, but I kind of feel we are getting somewhere in the campaign for greater understanding of mental ill health. I hope so.
And the relevance of the Budget could not be clearer. Henck was not being party political, and I have no idea what his politics are. But he rightly made the point that this new approach to the treatment of mental health problems was a government making a choice to invest in that particular aspect of health care.
As if we didn't know already, we certainly know now that there are going to be some very difficult choices in public spending in the coming years. As Tony Blair used to say 'nobody ever came into my room without a cause, and nine times out of ten, it was a cause that they thought could only be addressed by us agreeing to give them more money.'
The competition for resources will become fiercer. The commitment to finding the resources will have to be strong. But I for one am confident a Labour government will always have its heart in the right place when it comes to the NHS, has made some good decisions on mental health in the past, and will maintain that commitment in the future.
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Your – and Henck’s – points are so true, and so important. It is easy to trash the government for what it hasn’t done & everyone is recently keen on that bandwagon. It is also easier sometimes to quantify what the govt has done for “physical” healthcare (waiting times down from 18mths in 1997 to 8.6 weeks in 2009) as opposed to what they have done for mental health care.
But – really big but – innovations like the improving access to psychological therapies programmes will help so many people with mental health conditions with their quality of life, managing their diagnosis, coping & recovering, and doing so in an easily accessible way. The NHS will partner with charities like MIND to make it happen. That makes me proud of Labour.
great blog.
one of the first things i thought as i was listening to the doom-laden reports of the awful debt figures and the consequences for public services, was that I wouldn’t be at all surprised to see the government reining back on this particular mental health initiative.
The Improving Access to Psychological Therapies programme it’s called and from memory, £160 million has this year been invested in a network of centres where people can get talking therapy.
Great initiative, making a real difference to millions potentially.
Whether the further phases of the IAPT initiative will be delivered, remains to be seen. I don’t have as much confidence – for exactly the reasons you say – because mental health is not visible and high profile its easier to mothball plans for more talking therapy centres. The same couldn’t be done with cancer clinics, for example, unless the government has a real death wish.
Time will tell.
One of the other reasons why mental health is not more centre stage is that invariably, the clinicians involved are so far up their own arses, that they can’t see the woood for the trees. And as with most specialists, there is a real arrogance and talking down their noses to people. They won’t engage with a wider public and haven’t a clue about how to go about it. Ironic, given the work they do.
But Henck is one of the good guys, I think.
And very well done for all the brave and courageous efforts you have made to help drag mental health into the public arena.
“Exactly how and when the changes in attitudes came is impossible to pinpoint. But the change came.” – the beauty of this statement, for me, is that this change always comes – it sometimes takes days, weeks, months, even years but it does come – the frustration that I sometimes feel – is generally because of time – not because of values! I do appreciate you (AC) keeping the candle of value burning – some of those still at the coalface dont seem to be able to feel comfortable and at peace with that! don’t question or regret your optimism.
David
Labour may well, as AC says, have its heart in the right place but certainly not this particular manifestation of it.
Cameron’s remark about this being a “Government of the Living Dead” is spot on…..
A General Election followed by a spell in the wilderness should give you sufficient time to remind the Labour Party what it stands for.
Very interested in Mr Campbell`s contribution to BBC 2`s `The Speaker`. How many people are aware that Duncan and Irene (not to mention five other individuals who appeared in the second episode) attend the same state school in Bristol?
As a teacher who has worked with all of these youngsters, I am fiercely proud of what they have achieved. Every year we have to endure the endless carpings of the right wing press about how “standards are dropping” and how the private sector should “share its expertise” with the rest of us proles. These young people are living proof that our state schools are more than capable of producing bright,articulate,witty individuals who will soon be empowered to make the world a better place.
Alastair, great points regarding change in mental health attitudes. Also, excellent work in this area overall! Which is why I’d like to remind people to vote for you as MIND Champion of the year (deadline is April 30!!).
Here’s the link: http://www.mind.org.uk/About+Mind/mindawards/champion/mindchamp09.htm
Regarding the budget, you rightly point out that the crucial task was to find a middle ground between the unlimited expectations of the people and the very limited resources the government has to allocate for certain expenditure areas. This challenge has persisted in time and across countries, and I doubt the Tories would have done a better job at this.
The only mention I saw of the Tories’ views was their criticism of the measures and blaming Labour for the recession. Quick reminder: dishonest American corporate schemes started it all. Also, while GB was in charge of finances, he oversaw a great economic expansion. Therefore, any attempts to discredit his skills because of the current crisis are invalid.
This only proves that the Tories are the party of “can’t do,” “absolutely not,” and “don’t even think about it,” without bothering to consider the context of this recession, its roots, and lesson-drawing from other nations (U.S., Japan etc). Oh, and yes, they’re a bunch of flip-floppers!
If anyone cares to read some of their policy papers, you will see frequent references to U.S. (conservative) policies and suggestions about how they could be applied in the U.K. They have done this for crime, and most notably, for health policy, both of which would be disastrous in the U.K. However, when it comes to the budget, they depart from U.S. Conservatives (as well as from other countries) and deny the importance of running deficits in order to lift the nation out of depression. Let us not forget that U.S. bailouts started under the watch of President Bush and Treasury Secretary Hank Paulson. Also, Alan Greenspan famously revealed before a Congressional committee that his belief in the market and conservative approach to spending was shaken by the crisis. So here, there is some consensus among Dems and Reps that some spending must be done. But Cameron is very selective in his embrace of American conservatism, and seems absolutely intent on exploiting this crisis for political purposes even though this is so detrimental to the interest of the country.
Their proposals are nonsense. They say they would “get a grip on government spending, and use the savings from cutting waste to introduce real help now for families and pensioners: Freezing council tax for two years, worth over £200 for the typical family; Abolishing income tax on savings for all basic rate taxpayers, worth up to £7,200 a year; Raising the income tax threshold for pensioners, worth up to £400 a year; Help for the unemployed to upskill and reskill during the recession – and tax breaks for companies who create new jobs.”
Ok, this only shows their preference for positions that are politically expedient but economically inefficient. Which government programs are they going to cut? What spending will they reduce: for the NHS? For education? For unemployment benefits? If they don’t plan to extract any type of revenue, how are they going to pay for the “upskill” and “reskill” during the recession? Tax breaks to people, tax breaks to companies… these will slightly increase revenue to some categories of individuals and to some companies, but there is no guarantee that this revenue will go back into the economy to stimulate spending, commerce etc… Unless the government sets the pace for spending, those with revenues will be reluctant to invest their money. Economic transactions depend to a great degree on trust, and the government is best positioned to restore this trust.
Interesting. I did check the budget report for mental health and it comes under cost savings: “billions of pounds per year of cashing savings by extending the success of the NHS tariff pricing system into new areas, most notably community services and mental health.” However I don’t know what the NHS tariff pricing system IS – is it separate to the direct payments system? It doesn’t sound particularly good news to me.
The Speaker is successfully challenging negative stereotypes of young people.
The scene where the lad who was eliminated from the competition coped with his disappointment by pulling up his hoody was surprisingly powerful.
Hear, hear to T Crocker’s comments regarding The Speaker. ALL of the kids did so well & I have to say that I thought your comments to them were so encouraging and put across in such a caring way. It looked as if YOU thoroughly enjoyed the whole process too!
From one Englishman to another – Happy St George’s day Mr Campbell.
May England rise and throw off the last chains of empire.
Home rule for England.
Heard you on BBC Asian Network just now. Agreed that it was great to see young people being so passionate and enthusiastic about the power of words to make change. Agreed as well that the remaining contestants show a great face of young, modern Britain. I’m backing Maris. Must be hard for you knowing who’s won but can’t say! Amazing that two of the final five came from same school. They must be proud down there!
Dear Mr Campbell.
I am a student researching Mental Health awareness and resources within the PCT’s in Derbyshire and have also been doing presentations on the Time to Change campaign, as this is very close to my own heart. Would it be at all possible to interview you at all, via email as I know you will be one very busy man. I really want to make a difference for Mental health awareness and stigma’s attatched to it and would like some power behind the research.
Kindest regards
Amanda
Couldn’t agree more with everything you said, Alastair. Hopeful and inspiring blog entry, thank you.
Don’t mind those who attack your attachment to your ethnic heritage. British, English or Scottish, what matters is that you are a talented, kind, and generous human being. Keep up the good work.
Hopefully as New Labour we will still be in power carry on with improvements to NHS, the last thing we want or need is for a return to the uncareing Tories or a return to old Labour which i can see happeing under Brown/Darling
I know you always speak sympathetically and with kindness about the problems faced by the mentally ill. You are right about the need for more psychologically based therapies though, on this occasion, I think you have been carried away by the perceived merits of CBT. You are also, I believe, wrong about removing the gate-keeping role of the family doctor. Universal access to what is called “high volume, low intensity” health care (by the government, as quoted by Hanck van Bilsen) will be great for those with minor upsets, but will put those who have serious mental illness at greater risk
Dr John Crippen
http://nhsblogdoc.blogspot.com/2009/04/alastair-campbell-on-mental-health.html
@morning paper : re the NHS tariff system and what it is. It basically sets an internal NHS price to certain types of treatment – ie a hospital gets a set fee for say, a hip replacement, or a cataract op, in an attempt to set a level playing field for how money flows around the NHS system to fund treatment. There has not yet been a “tariff” for mental health, because it is more complicated to define how mental healthcare is delivered than boiling it down to a procedure. But work is under way, I believe, to crack that problem. Not same as direct payments, which are around social care funding.
@dr John Crippen. Think there is some triaging system (at least in the model of IAPT I am closest to) to channel people to the most useful care for them, and refer them to a GP if the issue needs more than CBT. There are checks and balances along the way to match care to individual need.