Increased privatisation of UK mental health services jeopardises patient care

By Ajanta Silva
19 June 2019

Notwithstanding the Tory government’s bogus promises for the National Health Service (NHS) via the 10-year Long Term Plan (LTP) to improve mental health services, harrowing stories of abuse, neglect and lack of services repeatedly make the headlines.

Drastic funding cuts, shutting down of mental health units, wards and entire hospitals, along with outsourcing of mental health services, have crippled the care that the most vulnerable people in society depend upon.

Years of funding cuts have not only put enormous pressure on emergency, ambulance and general practitioner services, they have exacerbated the suffering of people with mental health issues and learning disabilities, leading to increases in suicides and self-harm. Meanwhile, the treatment of people with mental health emergencies hundreds of miles away from their homes has become a regular occurrence due to lack of facilities.

In England, total bed capacity has been slashed from 160,254 in 2009 to 129,992 in 2019, according to official NHS England figures. Over the same period, available beds for mental illness and learning disability have been cut by a third, from 29,330 to 19,368.

Official figures show a drastic fall in the combined workforce of NHS England mental health nurses and learning disability nurses over the last decade, from 46,155 in 2009 to 39,549 in 2019. The number of doctors in specialist psychiatry training has plummeted by hundreds. Currently more than half of the mental health patients who need specialist care and support are first seen and taken to safety and care by the police, rather than specialist doctors, nurses and paramedics.

The main beneficiaries of this deliberate run down of services are the private companies who provide much of the available mental health services nationwide. During the Conservative-Liberal Democrat coalition government’s five years alone (2010-2015), 25 percent of mental health service contracts were awarded to private providers.

Although it is difficult to gauge the full scale of how much public money has been looted by private mental health care companies, several Freedom of Information (FOI) requests have shed some light on the sums involved.

In 2018, one such FOI request asked Hertfordshire Partnership NHS Foundation Trust how much money they had spent on inpatient beds in private psychiatric hospitals in each of the past five years. The data showed a dramatic increase. Hertfordshire spent just £1,126 in 2012-2013. In 2013-2014, this shot up to £222,284 and rose to £ 981,449 in 2014-2015, to £1,509,788 in 2015-16, and £1,463,838 in 2016-17. It should be noted that the huge rise from 2013-14 coincides with the introduction of the 2012 Health and Social Care Act, which allowed a vast increase in private sector involvement in the NHS.

In 2017, BBC FOI researcher George Greenwood reported he had sent FOIs to all 81 NHS mental health authorities across the UK. He wrote at the time, “From the 40 authorities able to respond in full, data shows the cost of treating patients privately went up from £71m in the 2012 financial year to a projected £101m for the 2016 financial year.”

Some recent documentaries and reports reveal the dire situation in mental health support and care.

*A BBC Panorama undercover investigation recently revealed the physical and psychological abuse and trauma suffered by patients with learning difficulties at privately run Whorlton Hall Hospital in County Durham. The private owner of the facility, Cygnet Health Care, issued a statement saying they were “shocked and deeply saddened” and suspended all the workers involved. But they did not explain how their business interests in maximizing the profits from NHS funding contributed to substandard care and institutional abuse.

Around 2,300 people with learning difficulties are in centres like Whorlton Hall, which are privately owned and profit from NHS funding. The hospital charges the NHS £3,500 a week for each patient.

*A second-year physics student at Bristol University, Natasha Abrahart, aged 20, who was suffering from social anxiety, committed suicide April last year. The coroner’s inquest recently held into her death ruled that a series of failures by mental health services had contributed to her death. Natasha had been referred by the university GP services to Avon and Wiltshire Mental Health Partnership NHS Trust in February 2018, following the first of several suicide attempts. The inquest found that there was “an unacceptable delay” in Natasha having a specialist assessment and her “risk of self-harm was not adequately assessed.”

NHS trusts have been forced to downsize their services and cut down bed numbers and staff due to the government’s funding squeeze. The inevitable outcome has been a devastating erosion of patient care and support. In 2017, Avon and Wiltshire Mental Health Partnership NHS Trust was looking to make cuts worth about £24 million.

*In April, The Priory Group, a private mental health care company, was fined £300,000 for breaching health and safety law following the death of a teenage girl in its care. Amy El-Keria committed suicide while receiving treatment at the Priory-owned Ticehurst House in East Sussex in November 2012. A previous inquest into her death, held in Horsham in 2016, was critical of staffing levels and training and risk assessment procedures at the hospital.

A Sunday Mirror investigation found “at least a further 11 deaths following failings in care at The Priory group’s clinics since her case” in 2012. They reported that “a lack of aftercare plans left some needlessly vulnerable to taking their own lives.” The private hospital group left suicidal “patients unattended, with materials that could be used to take their own lives” and “falsified records were identified as matters of concern in two deaths.”

The Priory Group, owned by US company Acadia Healthcare since 2016, has been funneled billions of pounds from the NHS and Social Services budgets. In 2017 alone, The Priory Group had total revenue of £797 million. The vast majority of this came from the public purse. It received £418 million from the NHS and £302 million from Social Services.

In May, Corporate Watch, a non-profit organization, published a devastating exposure of The Priory Group’s profits and tax avoiding arrangements.

Corporate Watch noted that the fine the company received following Amy’s death “represents less than two days profit for the Priory group, which made an operating profit of £62 million in 2017.”

The expose found:

The Priory Group gave its boss at the time of Amy El-Keria’s death a £458,000 “golden goodbye” when he left that year—more than half again what the company was fined for the suicide.

Priory has paid out £171 million in interest to owners Acadia Healthcare in the two years since the US company bought it. And Advent International, the US investment firm that owned Priory at the time of Amy’s death, made a £375 million profit when it sold the company in 2016. In the year Amy El-Keria died, Priory received a £1 million tax rebate from the government, thanks in part to a Channel Islands tax avoidance scheme set up by Advent International.

Even if the Tory government puts another £20 billion into the NHS, as a part of the Long-Term Plan (LTP), it is inevitable that this money will mostly line the pockets of private company owners waiting to plunder lucrative parts of the NHS. The LTP’s main aim is not the restoring of already crippling services millions of people depend on, but making the looting of the NHS easier.

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