Doubts over government commitment to Northern Ireland proposals

The government’s response to radical plans to reform Northern Ireland’s mental health and learning difficulties services has disappointed the sectors. Mithran Samuel reports

Last week, Northern Ireland health minister Paul Goggins announced how he would take forward a far-reaching review into
policy and services for people with mental health problems and learning difficulties.

But Goggins’ speech contained no specific funding, staffing or policy commitments. Instead, he said an inter-departmental task force, headed by a new director for mental health and learning disability, would handle the government’s response to the review and produce a service framework for each client group.

He was speaking at the final conference of the Review of Mental Health and Learning Disability, which began in October 2002 and has so far produced eight large reports, containing hundreds of recommendations, with three reports to come.

The review’s recommendations amount to a root-and-branch modernisation of services to reverse rates of institutionalisation and hospital care that far outstrip the rest of the UK, and bring inadequate resources in line with need.

Although many of the key proposals were issued over a year ago, in reports on adult mental health and learning difficulties, last week was when the government responded. A spokesperson for the province’s Department for Health, Social Services and Public Safety (DHSSPSNI) says the decision to respond now was because of the inter-related nature of reports to date, the latest of which was issued last month.

Ian Walters, chief executive of Action Mental Health, one of Northern Ireland’s largest mental health and learning difficulty voluntary providers, says that hardly any of the conference delegates felt encouraged by Goggins’ remarks. “What people were looking for was a very strong statement of support for the recommendations and a commitment to implement it and that takes money and that wasn’t there,” he said.

Despite the review calling for a doubling of resources over 20 years, Goggins merely said this would be considered alongside other health and social services needs as part of the department’s bid for next year’s comprehensive spending review.

And the DHSSPSNI spokesperson refused to confirm whether the proposals were a priority.

Walters, a former senior civil servant, says the minister broadly supports the proposals but the tightness of the 2007 spending review prevents him from making commitments.

Maureen Piggot, director of Mencap Northern Ireland, says the new director, who is yet to be appointed, needs to carry sufficient clout to drive forward the review’s recommendations.

The sceptical reception for Goggins’ speech is in total contrast to the widespread support for the way the review was carried out. Piggot stresses that it “broke new ground in Northern Ireland” in terms of user and carer involvement in its working groups and committees, adding: “The people who took these positions really demonstrated their value.”

Walters also says that its proposals were welcomed. “There’s nothing in the reports that people would disagree with,” he concludes.

Review proposals and government response

● The review called for a doubling in spending on mental health and learning difficulties. The government refuses to label it a priority.

● The review has made hundreds of recommendations since June 2005, including moving all people with learning difficulties out of long-stay hospitals by 2011. Goggins promised a service framework for each client group developed by an inter-departmental taskforce.

Review proposals
Mental health

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 Mithran Samuel


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