Congratulations
David Clark! In a Government where initiating a review has been a substitute
for doing anything, he has become the first Minister to have both established a
major review - into Mental Health - and to have received the final report of
the finished review, complete with a comprehensive set of recommendations.
But, unfortunately,
that is where it stops so far. The Mental Health review has made 40 specific
recommendations for change to a system that it describes as broken and long
overdue for major change. However, Dr Clark has indicated the Government will
not finalise its response until March next year. So, the prospects for urgent
action on the report’s recommendations are not high.
Assuming the
Government adopts the recommendations - by no means a certainty - the Minister
will need to have funding bids in for the 2019 Budget, meaning definitive
action is unlikely to come on stream before the latter half of next year at the
earliest. If new legislation is required to implement any of the recommendations,
it will probably be well into 2019 or even 2020 before it passes, meaning those
changes would not take effect until after that.
And some of the
recommendations are beyond the Government’s control at this stage. For example,
the recommendations regarding decriminalising drugs will not be able to proceed
before the recreational cannabis referendum, apparently now scheduled to be
held at the time of the next election. The government has yet to indicate
whether it will regard the outcome of that referendum as binding, and what
steps it will take in the event of a vote for recreational cannabis
decriminalisation.
So the path to the positive future recommended by the Mental Health review is a long and uncertain one yet. But none of this should detract from the importance of addressing comprehensively the Mental Health review’s recommendations. There are too many individuals and families suffering to allow that.
So the path to the positive future recommended by the Mental Health review is a long and uncertain one yet. But none of this should detract from the importance of addressing comprehensively the Mental Health review’s recommendations. There are too many individuals and families suffering to allow that.
And despite the
public expectation for swift action, due in part to the Government, as usual,
overselling its intentions, it is more important that the Government introduce
a comprehensive and integrated response, rather than an ad hoc and piecemeal
approach. And that will be a difficult balancing act because the public’s hopes
are so high.
In the meantime, the
Government may have to do something Labour Governments of late have been loathe
to do - make full use of non-government agencies and their skills and
experience. There are several hundred such agencies active in the mental health
and addictions fields, and there is no reason why they could not be utilised
more fully, alongside the services provided by District Health Boards. Indeed,
the review provides the opportunity to rationalise the respective roles of the
non government agencies and the District Health Boards, and establish a long
overdue partnership between them. The obstacle, though, is Labour's long held
view that such matters are primarily the province of the state to control.
The Mental Health
review opens up the possibility of the most profound changes since the Mason
Report of the late 1980s. The Government’s response in March must set out a
clear and integrated way forward, together with an interim pathway towards
achieving it.
Dr Clark may well feel
satisfied that the Mental Health review has been completed on time, and is
comprehensive. But for patients and their families, the agonising wait while
the review was underway will continue and reach its crescendo when the Government
responds in March. In that sense, the mental health challenge is now only just
beginning.
No comments:
Post a Comment