Let the bun fight begin
Well, well, well. Nothing like a political crisis to whip off the NHS gloves and start a bun fight over compassionate care. For those of you who have been slogging away in public service for decades, run anti-privatisation campaigns, gone to the rainy Tuesday night organising meetings and flushed your promotion prospects down the lav for the sake of the NHS, watching the spectacle of election promises can feel like a mixture of rare opportunity and taking a bullet. Suddenly everyone wants to talk. Repeatedly hurling truth at power about the sorry state of the UK’s mental health system should come with a health warning for anyone, especially to people clinging on to a political career. Who on earth has the guts to see a root and branch reform of failing services through to a healthy conclusion? The good news is that reality is a sobering thing and the lack of potential for shiny happy endings has brought some seriousness to the mental health debates. No longer do you have to be a Marxist to suggest that the profit making logic of large pharmaceutical and digital healthcare companies dominates the future trajectory of services. To note that we have a health system that has been downgraded sufficiently both to halt the prospect of caring and for the NHS to be a key financial target for digital companies is no longer radical. Nor is considered paranoid to note that the ‘digitaltherapeutics’ sector is already established in the USA, offering ‘treatment’ for the big health conditions such as diabetes and addiction. Biometrics and Apps, integral to the financial logic of governments to cut the costs of care but within this model a profound threat to anything resembling health combined with rights. As the American experience of sanctions against diabetes patients who didn’t do their exercise or forgot to type their data into an App, we have been warned that the computer often says no to the real and complex matters of mental illness. Biometrics gone mad. Nor is it mean spirited to say that it matters that Simon Stephens worked for United Health Group, one of the largest healthcare and insurance providers in the USA, as Vice-President, President and CEO from 2004-2014, immediately prior to taking up the position of head of the NHS. Read that again. Or that it matters that Matt Hancock thinks that GP services should be delivered virtually by online providers such as Babylon despite the very clear data protection issues that have emerged on his watch. You also don’t need to be Ken Loach to say out loud that our mental health services have been co-opted by the last decade of welfare cuts in the name of austerity. No, austerity is not over and if you or someone you love has come within a mile of Universal Credit you’d know that. If you’re lucky enough not to have any experience of this then please, accept with humility that you need to listen to people who have. Because a system of mental health and wellbeing ‘services’ has crept into the welfare system as an integral part of claiming benefits. No longer is it enough to need welfare to survive, you have to be happy about it. I wish that was funny. Increasingly the people delivering and receiving mental health services have a problem with this. A few weeks ago at the Mental Health Crisis Summit something quite remarkable happened. A group of service users and their families, workers and trade unions spent the day together to imagine what a good mental health service might look like. From a social model of mental health, to organising low paid workers, we put down our rotten fruit and ended the bun fights over resilience and wellbeing, and had a go at designing the first stage of a real mental health campaign. Whatever you think you’re doing when you’re supporting mental health in this country, you need to understand the state we’re in. So sit back and watch these videos of such grand folk as Ken Loach, Jon Ashworth, Denise McKenna from the Mental Health Resistance Network, Kevin Courtney from the National Education Union, Ian Hodson from the Bakers’ Union talk about the politics of mental health. There’s also a video of me, Elizabeth Cotton, here but all I can say about it is I do wish I’d had the sense to take out my chewing gum. Bad manners, but I still stand by what I say. Between us, we need to use our moment in the political spotlight to build a genuine mental health service.