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Joined-up thinking


Joined-up thinking

Like him or loathe him, Tony Blair came up with some memorable phrases. ‘Joined-up thinking’ was one of them. He frequently talked about how government should implement it in the way services were delivered, particularly across the divide between health and social care.

Recently this approach seems to have been adopted by David Cameron, though, naturally, he didn’t employ Blair’s words. He has just announced a series of reforms linking social care and mental health. These reforms, he promised, would deliver an “all-out assault on poverty”, with the focus on four key areas: family life and early years; education; equal opportunity; and treatable problems such as mental health and addiction.

According to Mr Cameron, the problem is not so much material poverty, it is more a lack of opportunity. The key, he insisted, was to improve family life, and, to this end, he promised to increase funding for relationship counselling and to provide careers guidance and mentors for young people amounting to £70m over the next five years. £70m? Really? That’s an average of £14m per year, to be divided between 32 London boroughs, 27 county councils, 55 unitary authorities and 36 metropolitan boroughs: not much, when you look at it that way, is it?

He also called for a “more mature” conversation about mental health: targets would be set for waiting times for teenagers with eating disorders and for people with first episodes of psychosis. Well, we all know what happens to targets, don’t we? Hospitals have been missing waiting-time targets for a long time and what has happened?

Mr Cameron also repeated previously-announced spending to 2020 of £290m to improve access to mental health services in pregnancy and after childbirth, and £247m to establish mental health services in every A&E department. If we divide that between 211 CCGs and five years, it comes out at £275k and £234k per CCG per year, respectively. Extra funding for services for addiction doesn’t get a mention.

Don’t get me wrong; extra money for our hard-pressed mental health services to provide better care for some extremely vulnerable people is always welcome, but the amount being made available is utterly inadequate. An ‘all-out assault?’ It doesn’t even come close. It doesn’t even qualify as joined-up thinking beyond the fact that initiatives relating to a range of aspects of health and social policy have been included in the same speech.

So what are we to make of it? If it is sincere, it makes me wonder whether Mr Cameron and his ministers are completely out of touch with the realities of poverty and mental healthcare and are clueless regarding what they should do about it. On the other hand, if it’s insincere, I leave you to draw your own conclusions.

Withering is the pen name of a practising independent community pharmacist. Withering's views are not necessarily those of ICP.


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