Welsh Assembly rejects central mental health commissioning

A controversial proposal for a central mental health commissioning body in Wales has been dropped by the Welsh assembly government.

Learning disability campaigners welcomed the decision, following concerns that a national authority would have led to services for the learning disabled becoming “sidelined and over-medicalised”.

But mental health charities were disappointed at the rejection of the proposal, floated in a report by housing and social care expert Michael Williams, earlier this year. Charity Hafal’s chief executive Bill Walden-Jones argued it would have created better quality and more “streamlined” services, while Mind Cymru said “radical changes” were still necessary to move services forward.

“Fragmented”

Professor Williams’ report said a single body was based on the need to establish a “fully integrated mental health service in Wales” and to replace a “fragmented” and “inadequate” system.

But in a written statement, health minister Edwina Hart said such an authority would have run “the risk of becoming isolated and stigmatised”.

“It will also depend on a complex weave of partnerships which could confuse and create boundaries to seamless working,” she said.

Consultation

She confirmed the decision shortly before announcing a major restructure of the NHS in Wales.

Focusing on the results of a consultation, which received 368 responses, Hart said opinions were divided on the proposals, with 44% against, 41% in favour, and 15% undecided.

Those against included health organisations and local authorities, which faced being stripped of their commissioning responsibilities. Service user groups and some charities had expressed enthusiasm, however.

In future, mental health services will be controlled by seven new integrated NHS bodies, replacing local health boards and NHS trusts. Responsibilities for delivering services will continue to be shared with local authorities.

The minister accepted arguments made by groups such as the Association for Real Change that including learning disability services within this body would introduce a “medical model” that could marginalise people who did not have mental health problems.

Cinderella service

ARC’s chief executive James Churchill was joined by the Association of Directors of Social Services Cymru in welcoming the decision.   

Walden-Jones was also pleased with the “worthwhile” consultation process and Hart’s promise to ensure mental health would no longer be a “Cinderella” service.

The announcement was followed by the launch of the Welsh assembly’s new intergenerational strategy, a blueprint to strengthen community relationships.

Related articles

Expert guide to mental health

External information

Association for Real Change – official website