Sunday, October 19, 2008

Mental Health Foundation Trusts Lack Patient Choice Vision ?

Whilst UK NHS Mental Health Trusts are making "surpluses" (£3.9 Million For the Last Financial Year at the UK Birmingham And Solihull Mental Health Trust) by shaving off activities such as better patient choice of therapies, it is becoming clear from BBC reports "Elite Trusts Lack Ambition" that a lack of deeper relational vision with patient needs is not just a local phenomenon.

The criticisms and concerns are coming from MP's and the oft quoted King's Fund - but what is best for the patient in terms of choice is being fought over - particularly in mental health by the legions of Dept Of Health related bureacracts that want everyone to believe that they know best and are advised by "experts" . A patient culture however of CHOICE which drives quality is left out of the equation . The patient is denied the expertise of their experience and even evolving that .

The slowness of the so called IAPT programme in the UK (Improvement To Access To Psychological Therapies) is not merely due to the national slow roll out of new CBT trained graduate psychologists but due also to the Foundation regimes at Trusts to "save money" and create surpluses subtracted essentially from patient need .

What UserWatch can reveal is a collection of Primary Care Trusts (Pan Birmingham Commisioners) who dole out money to the hospital based Trusts and Services are looking via on Online survey to Third Sector and charity supply of therapies - to take a measure of what is on offer .. No doubt the DOH with its heavy handedness and current Labour spectacles will try to cobble private supply approaches with perverse over-insistence on "objective evidence bases" in a field which is substantially patient-relational and often about the patient's relational pain in the world which connects to their difficult inner life .

UserWatch talking to patients locally and across the UK have heard a common theme about many NHS psychologists - namely the Psychologists have an irrational belief in an objectivity that tries to embed itself in the relational field of the patient without realising that its own stance creates substantial distrust and alienation of feeling related to .. Try being clinically "Observed" by others . Its paranoia inducing . Its as simple as that . Some psychologist need to be trained in relational psychodynamics which views the patient inside a relational field with them and the institution they are in . Either that, or get a microscope and change proffessions.

The demand locally in Birmingham UK for psychological therapies which match conditions that need mixtures of therapeutic support across the spectrum from severe neuroses (OCD) to Bipolar and Schitzophrenia, to Personality Disorders is still active though too often muffled because of the selective hearing and spending problem that exists at Trust Board levels - i.e. the demands to make savings ...

It is the State we at UserWatch believe that is holding progress back because patients are not allowed to drive therapy-choice and quality through being directly involved in purchase control too .

What is powerfully the case with Labour is their distrust of ordinary people to order their affairs when assisted in the right way . Labour only appear to have a "mixed-up" policy which tries to slowly morph the State supply sides into Third Sector and Charity suppliers and the merit in that is it may suppress the private sector supply costs but it also may put into an iron jacket the patient, who cannot importantly drive the chosen quality of the treatment-supply in style and time scales relevant to their lives ..

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