Monday, January 29, 2007

In The Shoah The Mentally Ill Were The First Jews

Its a few days ago now when human consciousness in parts of the world dwelled once again on remembering the catastrophic trauma SHOAH of the loss of millions of jews at the hands of the Nazis ...

So easily did parts of the SS and adminstrative german classes design new ways to burn bodies or gas them, and the first chosen were those with mental illness or mental deficiences ..

The world it seems makes a great difficulty sometimes of creating full witness to its misdeeds to others. Beyond the jews, our history if full of our sins and misdeeds towards our own kind . NO-one is free of that shadow. We are all flawed.

In mental health we are still treating people with discernible historical trauma's with drugs. We are still anti-narrative in the sense that there is a lack of supply of therapy for the human condition in its extremer experiences that become leftover as damaging states .

There are however some human beings who cannot let the idea of personal and shared witness die away without rescuing what went wrong .

To hold the vision of how and why we do wrongs to others is to hold a hope that from history we learn how to manage futures better.

Its a lesson that every family should learn and every clinician, psychitatrist , psychotherapist should also be a human historian that sees the human being as constructed and damaged by relationships in history rather than relationships between chemicals alone .

(In memory also of the 200,000 with Mental Health Issues first chosen to be killed by the Nazi's..)

Thursday, January 18, 2007

Is Sue Turner CEO Of The Birmingham & Solihull Mental HealthTrust Imbalanced ?

UserWatch shows here the reaction of Sue Turner CEO of the Birmingham & Solihull Mental Health Trust to a 123 signature petition signed by both patients and public asking for an Independent User Voice which has an accountable Committee of Managment to a patient membership and by implication not one that is self appointed (as it currently is )

A response to her report (below) to the Board meeting of Wednesday 24th January which appears like an attempt to crush debate before it begins, is expressed below her report) by an email of complaint from Paul Brian Tovey and it was copied to the PPI .

Dr Lynne Jones M.P. was also informed about matters and UserWatch hears the Non Execeutives have been approached with a view to rebalancing the views that have come out in that report .

Below from Sue Turner's Report Intended for the Trust Board on the 24th January 2007

"User Voice

User Voice comprises of 14 part-time workers and many sessional volunteers who have personal experience of mental ill health. Their role is to work at arm’s length within our Trust’s services with service users, focussing on the following issues:

  • to develop and enhance group advocacy and consultative processes across the Trust

  • to develop and enhance service user involvement processes on a day-to-day basis

  • to work with Trust managers and clinicians in eliciting and understanding service user experiences and feedback of Trust services

  • to work with Trust managers and clinicians in developing policy, action plans, and service improvements.

Evaluations of User Voice by both service users and Trust staff have been consistently good over the past three years; indeed complaints were received during the first year of the Trust’s operation because the number of User Voice workers at that time was insufficient to provide coverage across the whole Trust.

In December 2006, I received a letter which I originally believed to be from our local Public and Patient Involvement Forum requesting that User Voice be disbanded, and that a fully independent service user advocacy/involvement organisation be established in its place. This request referred to a petition which they had organised in support. I have now clarified that the letter and petition is from a small, independent group which some Forum members attend.

I have arranged to meet with the PPI Forum to discuss this further and propose to take the following stance:

  • User Voice is a Trust initiative and an important part of our operational governance processes.

  • User Voice concentrates on issues arising within the Trust and does not purport to be representative of wider community issues, or broader “service user” issues.

  • The Government proposes to redesign existing Public and Patient Involvement Forums. Specifically to affiliate the reformed function to Local Authority and align these to Primary Care Trusts in relation to their commissioning responsibilities, thereby increasing their ‘independence’ of provider organisations, thereby creating broader perspective.

  • Birmingham and Solihull Mental Health Trust supports further investment in service user involvement organisations and strategies. An independently-run User Council (external to our Trust) may be an appropriate development to pursue. However, any such proposals should be in addition to our own very effective User Voice, and not instead of it.

I strongly recommend that our existing internal User Voice be retained (indeed developed further), and would be grateful for the Board’s endorsement of the above.

The Email response to her reads :

Dear Sue ,

I refer to the language in your proposed CEO Jan 2007 report to the Board immediately underneath this email . I really must complain about it and ask that you re-balance matters by allowing reasonable process to take place.

The 123 signatured dual issue petition re: User Voice Independence (and the need for a patient constituency) was signed by both members of the public and patients and the majority of the PPI forum members and it is not intended nor has used the language that attempts to "disband" User Voice .

That sentiment is panicky and innaccurate .

Your CEO report is actually precipitate too because I have attended the last PPI meeting and the PPI forum are working on a way to retain User Voice functions whilst creating a realisable financial model for it to be managed by itself independently , using direct sources of PCT finance whilst being more independent of the Trust's senior management

It is eminently possible for an Independent User Voice as above to exist . A successful model like this exists in Derby (namely Derby Voice ) and it has the advantage of being more independent and stronger in its voice because it is not captured in a conflict of loyalty position by being in the pay of the Trust. It is not possible to work "arms length" as you put it, and be paid by the Trust . That is a contradiction in terms .

I will urge Board members to wait to see what the PPI forum proposes in the future .

I really must complain about your precipitate attitude here ..

I will copy the PPI into this email and others .

Paul Brian Tovey ..

Monday, January 15, 2007

LINKASSO MAN IS NETTED...(By Himself Probaby)

In Birmingham and further afield LINks are being discussed amongst PPI members and interested parties.

Quite what shape LINks will finally take as they emerge from Government dreamtime is anyone's guess. Whilst it appears they may have rights to inspect health premises - this might be a right narrowed down because "rights to visit" is one of the ways in which patients can be met and some PPI members know NHS Trusts see that as a danger of transparency . For all the talk of "patient democracy" what many have seen on the PPI's is their nobbling by fragmentation and by poor background adminstrative support mechanisms from CPPIH . In mental health there have been no extra supports such as special support groups from patient members. There appears to have been an almost deliberate slow take up of understanding of Section 11 patient & public consultation rights too by Trusts and Social Care bodies in the so called "joined up" mental health sphere ..

At least the questions about LINks shapes are being asked though and are being Hansarded From our source (Ms. RM) we learn :

John Baron (Billericay Conservative) 8th Jan 2007 :

Asks the Secretary of State for Health what the statutory basis is for the establishment of early adopter local involvement networks as set out in her Department's response to the consultation A stronger local voice; and if she will make a statement :

To which Rosie Winterton Sec of state for health answered :

The early adopter sites do not have a statutory basis. We are working with the Commission for Patient and Public Involvement in Health, the Healthcare Commission, the NHS Centre for Involvement and local stakeholders to build on their experience of involvement by looking at the structures required to empower and support local community engagement in health and social care, to help develop Local Involvement Networks

Also on the same day :

David Drew (Stroud Labour) asked :

The Secretary of State for Health when the model contract on the role for local involvement networks and their relationships with local authorities will be set out.

To which she answered :

The Government response document to "A Stronger Local Voice", published on Monday 11 December, provides some detail about the proposed model contract between local authorities and the hosts of Local Involvement Networks. This contract is being developed with the involvement of stakeholders and will be consulted upon in the new year. The Government response document to "A Stronger Local Voice" is available in the Library and can be found at the following website address:

(This was not available ! )

For links to "A Stronger Local Voice"


(See Also HERE if Link goes down )

Thursday, January 11, 2007

Local Involvement Networks (LINks) The Way Forward ?

UserWatch has learned from a source (Ms RM.) that in a question to Rosie Winterton when Keith Simpson (Con MId Norfolk) asked whether she would give the power to Local Involvement Networks LINks to inspect and monitor the NHS she answered :

"Local Involvement Networks will have the power to enter health and social care premises to observe and assess the nature and quality of services they provide. There will be full consultation on how these powers can be most effective and what excemptions are necessary to protect vulnerable people .


UserWatch can also report here on further information regarding making the Mental Health Service User's Voice properly represented in Birmingham. It learns that that the Birmingham & Solihull Mental Health PPI will have now been sent a "memorandum of association" which was used to create an Independent Users Voice in Derby by making it into a charity in 2004 . It has recently registered with the Charity Commission too. Although the Primary Care Trusts (the Funders of NHS Trust services) fund Derbyshire Voice they are in fact independently managed by themselves with a set of User Trustees overviewing the functions of the organisation ..

Tuesday, January 09, 2007

Patient's Forum Breaks Out Userwatch Told

Userwatch has had it confirmed that a statutory Patient's Forum in London tired of the chopping and changing of the PPI policies of the DoH and its poor support for patient and public involvement has broken out of the uncertainty-cycle by declaring itself independent. In an agreement with those in charge at the London Ambulance Service Trust the forum has formed a company limited by guarantee and is set to continue its valuable liaision work without interruption from Goverment :

Click on the image (left) to enlarge in your browser.

Its full statement reads :

Tuesday January 9th 2007 -

Patients Forum Says ‘No Minister’!

A Statutory Body established by Parliament to monitor the London Ambulance Service (LAS), has rejected attempts by Secretary of State, Patricia Hewitt to abolish it. The abolition proposal contained in the recent ‘Local Government and Public Involvement in Health Bill’ will set-back patient and public involvement in the NHS and hamper efforts to improve patients’ services, say Forum members. Legislation to abolish the highly successful and popular Patients’ Forum will be ignored by Members of the Forum, who will instead continue to monitor the LAS on behalf of patients in the same way and seek funding from other sources.

Said Forum Chair, Malcolm Alexander:

Forum Members are doing a great job, have strong links with communities and patients across London and have developed strong and effective links with the LAS. The Government’s abolition plans would destroy the Forum and set back patient and public involvement. Our Members are committed to working with patients and the public to improve NHS services and have no time for the Department of Health’s repeated reorganisations. Our Members have decided to resist the Secretary of State’s abolition plan and continue their work to improve ambulance services and to represent London’s patients and the general public in the NHS.”

For more information please contact Malcolm Alexander, Chair of the Patients’ Forum for the LAS or Mary Arayo, Vice Chair of the Forum. Malcolm Alexander: 0208 809 6551 or 07817505193 (m)

also email :

UserWatch is aware that the Birmingham and Solihull Mental Health Patient & Public Involvement Forum is keenly watching events and currently is looking at trying to help mental health patients obtain a robuster and more independent patient voice mechanism in Birmingham ...

See also stories below at Nick Green's independent PPIFO site


Health Committee PPI Inquiry: Some submissions

Draft submission The Purpose of PPI and the Design of LINks from Martin Rathfelder of Socialist Health Association

Mike Cox makes detailed recommendations. On the creation of LINks, recommendation 3.2, he says "CPPIH should be immediately removed from the re-organisation process and this should be conducted by a federation of service users and carers." Mike wants better treatment of disabled service users. His criticisms were claimed to be defamatory and CPPIH lawyers closed down his PPEyes website. He includes his dossier of CPPIH Incompetence.

Mandy Lawrence is critical of the running and organisation of Mental Health PPI. Secretive Trust members have been present at meetings "who use bureaucracy and red tape to block questions and concerns". Mandy's blog addresses these questions further.

Neil Woodnick submits Forums were "ill conceived from the start" with "significant departure from the policy originally discussed in the House.". The minister, David Lammy, advised the Health Committee that support for Forums was to be outsourced: these "FSOs failed completely to promote Forum awareness".

Paul Tovey "Patient & Public Involvement In Mental Health The Ethos And Realities And Evolving LINks". While focussing on long term mental health Paul asks for LINks that can commission research.

PPIFO submission "Patient Safety and the Autonomy of LINks". Thanks for the improvements.


Wednesday, January 03, 2007

Are Mental Health Charities Back Door Civil Services ?

The national mental health charities behave as though they are often the voice that represents the concerned cross-organisational standpoint over services that affect the UK "Users"

The truth though is more complicated by their self interest and their sector career needs to survive, together with their knowledge that their sector is set to pick up potential injections of political support as the NHS services are so called "opened" up to more "choice" ...

The new Social Enterprise Unit has been set up by the Govt in 2006 and is looking for "trailblazers" which might show the way to provide more patient orientated services.

The evidence though appears to be the charities are often combining to produce a very slippery notion of quite what it is they really support. We might argue if they supported "Patient Choice" then they would be glad to support marketising service delivery on the basis that Service Users could make genuine choice about what services are to support their own individual longer term management of difficult lives with difficult symptoms..

Userwatch in this new year will bring some stories about this sector and its ambitions to develop as a bigger default "notional" voice in the absence of patients themselves having a real democratising consumer led choice of supportive treaments for the longer term.

Prof Nick Bosanquet's latest document amusingly called "The empire strikes back" (Download from here) shows the NHS is striking back at reform which in Mental Health terms must mean if the mixed economy (part market) approach is not in the ascent then the Charity Sector will probably be used as the buffering tactic by politicians .

This does not make more informed MH Users very happy since charities are quasi corporate organisations that have showed a underlying duplicitous ethos of currying favour with Users whilst selling out their broader choice interests with carefully chosen language to soap up Govt policy evacuations - Suddenly for instance in 2006 Cognitive Behaviour Therapy was issued forth like "Choice" and a big hurrah went up when the computerised version of it came on stream.

In Birmingham and further afield wiser Users about the human condition, said it was like a one armed robot - but at least it had two policy fingers sticking up from it .....

What can they mean ?

UserWatch thus alerts its readers to make their own "Watches" and see how events are likely to roll out in 2007 . Once again however, it has to be stated that without the cost wasting NIMHE at 65 million quid up to 2006, Patient Choice might have been piloted directly more widely and better from the same money. As it is some wasteful energy and money was put into "Anti Stigma campaigns" and some twisted "Social Inclusion Ethos" which has been used by Trusts (and definitely Birmingham And Solihull Mental Health Trust ) to dilute services, save money, cause distress to Service Users on the back of some of the dubious work arranged by the MH Charities themselves which was fed into Government circles ......

Userwatch will discuss this further on into 2007

Happy New robotic CBT two fingers this year ........