Govt response to recession’s mental health crisis is all talk

No, really. Talking therapy.

As the UK economy slides further into recession, the prospect of millions out of work is putting pressure on individuals and families. Health secretary Alan Johnson and the minister for work and pensions James Purnell have announced more funding for mental health services to assist those made redundant by the economic crisis.

But what help is “cognitive-behavioral therapy”? Is it just a way of pacifying people who will be angry and upset that their hopes of prosperity are being ruined by the chaos of the capitalist system?

CBT encourages people to think about what they can do as individuals to improve their situation. Obviously, New Labour types like Johnson and Purnell would not naturally be promoting a therapy that encouraged people to look at how they can collectively overcome social problems – nor acting to prevent a mental health crisis by intervening in the economy to defend workers – but surely the failure of market fundamentalism to deliver “an end to boom and bust” should encourage politicians to think outside the box…

The Mental Health Foundation is calling on the government to treat the mental health epidemic caused by the recession as a public health issue:

The growing gap between rich and poor has caused a “social recession,” leading to low educational achievement, increased violence and poor community cohesion [...]

The Foundation warns that “perpetual stress” and depression linked to public concern over excessive earnings has led to widespread social and health problems.

Radical shift

The charity’s report, Mental Health, Resilience and Inequalities, calls for a “radical shift” in understanding mental health as a public health issue, citing research from around the world that shows that affluent but unequal societies can have many problems.

It also recommends assessing all future public policy for its impact on people’s mental health.

Social problems

The report’s author, Dr Lynne Friedli, said individual and collective mental health and well-being depended on reducing the gap between rich and poor.

“A large divide leads to a mentally unhealthy society, and many associated social problems. In the UK in particular, we’ve failed to acknowledge this link, preferring instead to blame the health and social conditions of those living on or near the poverty line on their own lifestyle choices. This in turn further stigmatises poverty, making disadvantage even harder to overcome,” she added.

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, said living with inequality had “very real effects on the mind and body,” adding: “Given the huge social costs of poor mental health, it’s vital we begin to treat it as a public health priority.”

English NHS doesn’t need polyclinics, study shows

So, will New Labour’s plans to open up GP services to big business be halted by the facts? Obviously not, but it is worth noting who the victims will be in this case (aside from the patients who might suffer worse services) it will be middle-income professionals.

Consider also that the English NHS is controlled by the British government. Would an English parliament make it easier to resist corporate takeover of public services? Who knows? But it is interesting that polyclinics are not being considered in Scotland or Wales…

From the BBC:

Average-sized GP surgeries are just as good as “super-surgeries” at providing extra services, a study suggests.

Ministers in England have asked health chiefs to create a network of polyclinics to provide extra care, such as diabetes clinics and minor surgery.

But a Kent-based GP’s study of 384 practices found no difference between the range of extra services offered by standard surgeries and polyclinics.

The government said polyclinics would provide a valuable service to patients.

Every NHS trust in the country has been told to set up at least one polyclinic, with a whole network being created in London.

Ministers believe the super-surgeries are the best way of moving care out of hospitals and into the community.

But the study by Dr Hendrik Beerstecher, who specialises in research, found large surgeries already operating were no better at providing the specialist care the government is so keen on.

He looked at the range of extra services, beyond the average package of GP care, being provided by a range of different-sized practices up to ones serving a population of more than 30,000.

He found small surgeries – classed as having fewer than 6,300 patients – tended to provide less diverse extra services.

But once the threshold of 6,300 was reached – the average size for a practice in England – there was little difference no matter how big the surgery was.

On average, these had between 10 and 11 extra services.

‘No evidence’

Dr Beerstecher, who is not a member of the British Medical Association, the doctor’s trade union body which has campaigned against polyclinics, said: “I am not sure why the government is pushing ahead with polyclinics.

“As the study shows, there is no evidence that they provide more services so why are we having them set up all across the country?”

Dr Richard Vautrey, the deputy chairman of the BMA’s GPs committee, said: “This proves what we have been saying all along – that we should not be rushing headlong into setting polyclinics up.

“GPs have always been innovative. You do not need a big surgery for this to happen.”

Gordon’s new year resolution should be to bring all the troops home

The war in Afghanistan isn’t going well. Not for the forces battling there and certainly not for the civilian population. The people of Afghanistan need bread, not bombs. If the plans of the US government to increase the numbers of troops fighting go ahead, casualties on both sides will increase – meanwhile reconstruction work will be further sidelined and aid agencies will be unable to operate inside the country.

This must be the last Christmas that our armed forces spend in the Middle East. They are owed an apology by those who sent them, and the people of Iraq and Afghanistan deserve to see a war crimes trial take place as soon as possible.

From the Morning Star:

Medics reveal massive cost of Afghan war
(Tuesday 23 December 2008)
by PAUL HASTE

ANTI-WAR campaigners urged the Prime Minister on Tuesday to make a new year’s resolution to bring home in 2009 all British troops involved in the “colonial” Afghanistan war.

The call came as British army medics revealed the mounting cost of the war, now in its eighth year, on young soldiers sent to prop up an occupation that is increasingly beset with problems.

Never-ending massacres of civilians by Western warplanes, rising casualties among the US-led military forces and insurgent attacks that reach deep into neighbouring Pakistan to destroy vital weapons supply lines confirm the increasingly intractable nature of the war.

Working at a British military base in eastern Afghanistan, Royal Army Nursing Core medic Lee Collins admitted that “we’ve got a constant flow of casualties on a daily basis here.”

Mr Collins explained that he works 12-hour shifts, while his “day off” has to be spent on call in case of emergencies.

Navy Commando squadron medical assistant Kate Parkman added that she expected Christmas Day to be “a normal working day,” describing her work as a Quick Response Force medic loading wounded soldiers into helicopters.

“A soldier had stepped on a mine. He lost his left leg and some of his fingers and he suffered severe facial wounds, but, by the time he had left us, we had controlled his pain,” Ms Parkman related.

“You get all this training on dolls with make-up, but it’s different here.”

Some 135 British troops have been killed so far during the occupation of Afghanistan. Almost 1,000 other Western soldiers have also died, but the number of Afghan civilians that have lost their lives is literally uncountable.

US military commanders refuse to count the casualties that their air strikes and “counterinsurgency” tactics cause among the Afghan people, but independent researchers estimate that the occupation has caused almost 28,000 deaths.

This toll, plus the British medics’ experience in dealing with their comrades’ injuries, prompted Stop the War Coalition spokesman David Wilson to call for an end to “this bloody colonial war.

“We have finally admitted its time to leave Iraq, but Gordon Brown should go one step further and make it his new year’s resolution to leave Afghanistan,” he declared.

“There will be no end in sight for this intractable and dangerously unstable occupation unless all the troops are brought home in 2009.

Feeding the poor to sharks?

Crypto-Tory James Purnell (if he was Labour, it’d be Jim) might be good-looking but he isn’t quick-thinking…

The govt wants to privatise the social fund and charge loan-shark rates on what are currently interest-free loans given to the poorest in our society.

There’s all to play for, mind you, and this suggestion could fuel the resistance to the so-called “welfare reforms” which are aimed at cutting the benefits paid to the sick and unemployed.

Given that Purnell is the face of the government’s so-called “welfare reforms” he’s not left sufficient space between one dodgy policy and the next. Hence the commotion.

Note that the Daily Mail isn’t outraged. If it was, the title of the article would be a great deal more urgent and certainly shorter:

Labour MPs revolt over Brown’s plan to charge 27% interest on emergency loans to poor

Gordon Brown and his Work and Pensions Secretary James Purnell were last night accused of behaving ‘like loan sharks’ over plans to slap punishingly high interest rates on vital loans to the poor.

In an astonishing move, rebel Labour MPs joined forces with David Cameron’s Tories to accuse the Government of penalising hundreds of thousands of families on benefits who get interest-free cash advances to cover the cost of unforeseen crises.

More than one million individual loans worth over £600million were paid out from the Government’s social fund last year to hard-up people – many of them disabled – who struggled to afford to repair a broken boiler or cope with some other domestic emergency.

However, in a provocative move, Mr Purnell wants to start charging 26.8 per cent on new loans – the sort of punitive rate found on High Street store cards and way above normal credit-card rates.

This would add nearly £50 to the cost of an average £433 loan and saddle the borrowers, who are almost all on State benefits, with an extra four weeks of repayments.

Senior Labour MP Terry Rooney, chairman of the Commons Work and Pensions Select Committee, led an all-party attack on the proposal. ‘Whoever dreamed this up, particularly at this time of year, must have lost their moral compass,’ he said.

‘It cannot be right to start charging almost 27 per cent interest on loans to the poorest people, who currently pay zero interest.’

Mr Rooney believed that the plan, outlined in a consultation document produced by the Department for Work and Pensions, was a cynical cost-cutting ploy to stop poor families getting the money they need.

He added: ‘I fail to see how Mr Purnell can reconcile raising interest rates for the poor with the Prime Minister’s repeated calls to the banks to pass on interest-rate cuts to struggling mortgage holders. There will be one hell of a row over this.’

Ronnie Campbell, Labour MP for Blyth Valley, said: ‘James Purnell makes me ashamed to be a member of the Labour Party. It is a disgrace the way he is hitting the poor. Not even the Tories would try to do this.’

Labour MPs also suspect that Mr Purnell is worried that the cost of the social fund will rocket as unemployment soars and thousands more people apply for help.

In an embarrassing development for the Government, Labour MPs received support from Tory Work and Pensions spokesman

Chris Grayling, who called on the Government to scrap the plan. ‘This is beyond outrageous,’ he said. ‘It’s nothing more than James Purnell and Gordon Brown re-inventing themselves as loan sharks.

‘That any Government would even consider imposing swingeing interest rates on unemployed people in the middle of a recession is just extraordinary. It’s a sign that this Government is utterly out of touch with what is really going on in Britain.’

And Liberal Democrat Treasury spokesman Vince Cable said: ‘This proposal is perverse and inhumane. The principle of social funds is that they are interest-free to help people cope with emergencies.’

Mr Purnell’s document, which suggests that non-profit-making credit unions could run the loans, spells out in stark terms how the poorest families in Britain would be hit hard in the pocket under the new system. It says: ‘Interest would be charged …at affordable rates compared to those charged by commercial lenders in the same market.

‘We propose to set it at the maximum charged by credit unions of two per cent per month – 26.8 APR.

‘In 2007-08, the average initial budgeting loan award was £433.30. The estimated average loan repayment for all loans was £10.54 a week. If interest were charged at two per cent a month, it would take 46 weeks instead of 42 to repay such a loan at such a repayment rate, with a total interest paid of £47.80.’

Mark Serwotka, general secretary of the Public and Commercial Services Union, whose members administer the social fund, said: ‘This might start with credit unions, but it will become a Trojan horse for the private sector to charge loan-shark rates for distributing public money.

‘It is scandalous that in these dire economic times, vulnerable people in financial difficulties could be exposed to profiteering. Interest of 26.8 per cent rates alongside some of the most expensive store cards.’

But the Government hit back last night, saying that under the proposed scheme, hard-up families would benefit from new advice on how to manage household budgets.

It said it would also be easier and quicker to get the loans, which would become available to working people on low incomes as well as those on benefits.

In the consultation document, Mr Purnell signalled that simply handing people interest-free loans without financial advice did little to help them manage their money.

‘We want to improve the help we give people when many are struggling,’ he said. ‘The social fund helps with money problems in the short term, but not the underlying problems of managing a limited budget.’

Last night, Work and Pensions Minister Kitty Ussher conceded that there was ‘very strong opposition’ to the plans.

But she dismissed the idea that the social fund was heading for loan-shark levels of interest, pointing out that ‘doorstep lenders can legally charge 180 to 240 per cent. Illegal loan sharks have been known to charge up to 1,000 per cent’.

It is not the first time Gordon Brown has been accused of betraying the poor. As Chancellor, he was criticised for approving a meagre 75p-a-week increase in the State pension. And this year, he was forced to climb down over his decision to scrap the 10p tax rate.

Hat-tip: Harpymarx

Drop the dead dogma – privatisation isn’t efficient or cheap!

Two items from Tribune on health and education show that New Labour are far from burying the failed neo-liberal model.

First, healthcare:

UNISON has urged the government to rethink its whole approach to NHS reforms in the wake of a damning new report on the cost of commissioning and outsourcing in the health service.

The public sector union has called on the Secretary of State for Health, Alan Johnson, to concentrate on giving NHS patients the care they need and deserve – as well as ensuring the taxpayer gets real value for money – rather than using health service reforms as a smokescreen to outsource or privatise services and “throw precious money away to the private sector”.

The call comes in the wake of a hard-hitting new report – called Driven by Dogma – from the Office for Public Management. In a damning verdict it says outsourcing in the NHS has failed to deliver value for money, proper patient involvement or improved working conditions for staff.

The Government’s pre-Budget report made much of the potential efficiency savings to be made by the NHS from shared service operations with the private sector. But first hand evidence in the new report, examining the experience of those commissioning and delivering services, reveals that promised cost benefits have failed to materialise and quality has suffered.

Unison general secretary Dave Prentis said: “At a time when finances are increasingly tight, the NHS cannot afford to be throwing precious money away to the private sector and wasting time and resources on the complexity of the commissioning process.

“Patients want more involvement in decision-making and staff want to spend more time on providing excellent patient care rather than tendering for contracts.

“Unfortunately, this report shows that the various reforms to outsource or privatise parts of the NHS are working against these goals.”

The union says there are realistic alternatives – Scotland has recently announced it will no longer permit any contract cleaning and Wales has done away with the purchaser-provider split in favour of a more sensible and user-friendly integrated system.

Second, education:

TRADE unions have hit out at plans by the Office for Standards in Education, Children’s Services and Skills to privatise parts of the schools inspection service.

According to a leaked memo, Ofsted intends to outsource inspections of early education and childcare provision early next year.

It says privatising early years inspections – which ensure nurseries, pre-school provision, summer play schemes and childminding services are safe and secure and meet educational standards – will “provide better outcomes and save money” but Unison, the PCS and the FDA senior civil servants’ union say the idea is wrong is principle and bad in practice.

Unison national officer Jon Richards said: “It is outrageous that Ofsted is privatising early years inspections. Parents need to have confidence in the inspection system and know their children are safe and will be well cared for.

“There is a very real danger that jobs will go and the quality of inspections will fall if the focus shifts from raising and maintaining standards to cutting costs and making a profit.

“The decision to privatise inspections has serious implications for staff, parents and children.”

PCS national officer Neil March said: “Introducing the profit motive into inspections, combined with the naive belief that ‘the market’ has all the answers, will end in failure and further demoralise dedicated staff. It will lead to corners being cut and a loss of expertise.”

The unions think Ofsted wants to “wash its hands” of staff. Mr Richards said: “It has hundreds of equal pay cases outstanding and this is a crude attempt to deal with the problem as the workers pursuing these claims will be the ones to go.”

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