There’s a book called ‘The Naming of the Dead’ by Ian Rankin. The title comes from a section in the book when Rebus the detective, contemplates his job and concludes that most of what he does is naming the dead. To name who died, why they died and who was responsible. Sometimes it can seem pointless, but it’s not. Naming someone means that they matter. Telling what happened to them and who was responsible is basic justice. And when I get weary of blogging and wonder if there is any point, I remind myself of that. At the very least, record what happened. Why it happened and who was responsible. It means that when things go belly up like they did at Stafford, everyone will know why it happened and who was responsible. And so in this post I record what is happening to mental health services in my area, North Lanarkshire. Who is slipping through the cracks and why.
It all goes back to a document called ‘A Picture of Health’ that NHS Lanarkshire (NHSL) brought out in 2005. The main bone of contention was the downgrading of Monklands Hospital from a level 3, to a level 2 hospital, but in amongst the bumf was their proposals for mental health. The basic plan was to build two new 112 bed wards, one for North Lanarkshire and one for South Lanarkshire. This was very quickly modified to two new 55 bed wards, then one new build and one refurbishment. In addition to that there were plans to shut Hartwoodhill, which takes patients with long term severe psychiatric disorders and brain injury. Where they were going to go was anyone’s guess; it was mooted that they would be found places in the community and in nursing homes. When I asked the then health minister Andy Kerr what nursing homes were going to take these people, he didn’t know and neither did his civil servant, which is when you really have to worry.
All of this happened before May 2007, which was the Holyrood election. When the SNP got in and reprieved Monklands as a level 3 hospital, NHSL had the perfect excuse to cut mental health services. And this is what they are going to do.
Acute mental health needs 153 beds. NHSL are going to provide only 130. In addition to that, 20 of those beds are going to be set aside for alcohol/drug rehab. NHSL used to buy this service outside the authority; it is now going to provide its own beds, but at the expense of 20 acute mental health beds. So we actually only have 110 beds for acute mental health.
Hartwoodhill and Caird House, which both take the same kind of patients are closing. There are 72 patients altogether from these institutions. 27 have been moved into Coathill, which is a hospital for the elderly; the elderly have been moved into the orthopaedics ward in Monklands hospital, and orthopaedics has lost 27 beds.
For the rest a new facility is being built called Beckford Lodge. It will be a medium secure unit and it will have only 27 beds.
So as I said; there are 72 patients. 27 beds at Coathill + 27 beds at Beckford Lodge = 54. 72 -54 = 18 patients with brain injury/severe psychiatric disorder without a place to go.
So how many beds are we losing in total? 43 beds in acute mental health and 18 + 8 unoccupied beds from long term psychiatric care. That adds up to 69 beds lost from mental health services altogether or 27% of capacity.
Where will these people go? Who is going to look after them? That’s anyone’s guess. Most of them will end up in the hinterland between the NHS and social work funding pots, known as ‘care in the community’. Some might be lucky enough to be adopted by a local church; my own church gives employment and protection to a group of adults with learning difficulties that live in sheltered housing near the church hall. Others will simply fade into the anonymity of the community will all its casual cruelties to anyone who doesn’t ‘fit in’. And some will slip through the cracks altogether, turning up in the ‘death by misadventure’ statistics.
How sly we have become with ourselves. How the mind will manoeuvre itself so that cuts become rationalisation, abandonment becomes care in the community, negligence becomes death by misadventure. God know what is going to happen in Lanarkshire when these measures fully kick in. But I record here and now what has happened and I ask NHSL, the media and all ; is it nothing to you, all you who pass by?
