What Was Said On The:-
Notes of Meeting 8th August 2008 at Therapy Centre, Park House.
Meeting with Ivan Lewis MP, Minister for Mental Health.
Chairman (Alan Hartman) opened the meeting
• List of forthcoming meetings of interest to service users circulated
• The MUN proposal for Patients’ Council has been forwarded to Manchester Mental Health and Social Care Trust (MMHSCT) but no response as yet.
• MUN report on user views about day services review and other matters has been sent to Manchester Mental Health Joint Commissioning Executive (JCE). Response awaited.
• MUN has previously voted to support the reinstatement of Karen Reissman (KR) who was dismissed from MMHSCT. KR asked that users concentrate on improving mental health services rather than further pursuing her case. A further vote in favour of her reinstatement was proposed, seconded and agreed by the meeting by majority show of hands.
• MUN has previously called for the resignation of the MMHSCT chairperson because the group lacks confidence in her engagement with service users and their views. A further vote on this was proposed, seconded and agreed by the meeting by majority show of hands. Chairman pointed out that formal complaints about appointed persons, e.g. the chairperson of a trust, should go through the Appointments Commission and that only 60 complaints were made nationally in the last year of the whole country. (Over 10 Complaints have gone to the Appointments commission
• The chair raised a point from recent discussions with MMHSCT that they appear to expect users’ dissatisfaction with services to be reflected in formal complaints. The chair pointed out that this is a course of action that is difficult to follow because of need to fill out forms. Many service users would be reluctant to make a complaint but still feel that their views should be heard.
Ivan Lewis MP
Chairman introduced Ivan Lewis (IL) saying that he has worked for many years in the past in mental health in voluntary and paid capacity and has always dealt fairly with the users’ groups. He has supported the need for a genuine user voice to improve services and was the first MP ever to attend a user group meeting. He is now the first government minister ever to do so.
Chairman informed IL about previous votes taken in the meeting.
- • Chairman has sent MUN proposal for patients’ council to IL and asked for comment. IL said that users should, in principle, elect their own representatives. There are problems when it is not clear who a representative is representing and they should not just represent their own views. MUN secretary pointed out that the MUN proposal has been discussed and supported at a National Social Inclusion Forum meeting.
• IL asked that he should hear the views of the meeting about how they feel services should improve. This is more important than going over old grievances with the Trust when there should be new opportunities now for a fresh start. There is general agreement that NHS patients need a stronger voice although there are other voices to be heard, e.g. clinicians, carers.
• IL said he was not aware of MMHSCT structures for user participation.
From the floor; as a LINKS representative the Trust board had not welcomed involvement but now had LINKS as observer. One service user sits at board meetings (status not clear from this discussion) but has no contact with MUN and MUN do not feel he represents service users.
MMHSCT provide MUN with an office at Park House.
Mental Health Joint Commissioning Team (JCT) runs a forum for everyone to have a say (Stakeholders Engagement Forum).
• Secretary pointed out that MUN is recognised as a formally constituted group by the Scarman Trust and the Community Foundation. It has members across Manchester and is frequently consulted by the press and other media. The Department of Work and Pensions have dealt with the group as representative of users’ interests.
• From the floor; Having a Voice, a user led organisation had its funding withdrawn and had to lay off staff.
• From the floor; MMHSCT managers have come to MUN meetings by invitation but relations have got worse lately.
John Boyington consulted with MUN in preparing his report on mental health services. He advocated greater user involvement.
• Chairman commented that the user groups were more active in improving things for users in the past, e.g. producing a user help card, but have now been forced to be more reactive to service management because not listened to.
• From the floor; I feel treated rudely and with contempt by some Trust staff and managers since I was involved with user group. I feel the user group can force more respect.
• Chairman; The Change in Mind changes have made services worse for me. I have to rely on other service users for support.
• From the floor; I have used services for 25 years. I was asked in 1997 what services I wanted and said I need depot clinic and drop in service. I was listened to then but now services have got worse. I feel unsupported.
• From the floor; The women’s group and the walking group have been lost. It should go back to how it was.
• From the floor; What tragedy or death needs to happen before services help us? We used to have good 24 hour services from nurses when in crisis. Now Pearl Unit just deals with you on the phone and tells you what is wrong. We used to get a home visit in a crisis with an assessment and help to sort things out. Change in Mind has removed such services. A week ago someone died because help was not available. We need 24 hour accessible emergency services. It took me 10 hours to get a distressed friend to hospital, a patient helping another patient, crisis resolution service said they could not come out and help. The Samaritans were more help. After a 6 hour wait at A&E my friend was prescribed valium, saw a doctor for 7 minutes and sent home in a taxi. I was asked to watch her for risk of suicide. We need the Government to ensure we get good services.
• IL; The Government cannot control all local trusts. This Trust has been malfunctioning for years. The implementation of changes has gone badly wrong. Significant numbers of people have been left in a bad situation.
• From the floor; Nothing happened when the Trust chair promised the user group she would sort out crisis resolution services.
• From the floor; (nurse care co-ordinator) There is no management of the Trust board from above. A lot of money has been wasted and management is top heavy. Need to start again with the Trust. They are not accountable.
IL; The Strategic Health Authority (SHA) commissioned the (John Boyington) report. You are entitled to good leadership and management. Patients should influence and trigger change but managers should still have the responsibility to manage. Staff and users have been let down. Manchester’s mental health services are not good enough and this is down to bad management.
• From the floor; There is a difference between consultation and involvement. There were consultation meetings for the older people’s mental health strategy but no involvement of users in producing the report. Also, there are different services in different Manchester districts. Services are being cut. There are no therapeutic activities and nothing to do for patients in hospital wards.
• From the floor; Why does it take so long to get an operation? I have to wait 4 months
IL; There have been big improvements, form years waiting to months.
• From the floor; How can we have greater social inclusion and integration to society when medication numbs performance? The government is pushing the movement towards employment.
IL; Stigma, prejudice and discrimination is still a big issue. The government is spending £80 million with four charities to tackle stigma. The expansion of psychological therapies in primary care will support people but Manchester is still a long way behind. Lots of people want to make a bigger contribution to society and we need to help with this.
• From the floor; Crisis resolution keeps coming up. This has been discussed by the SEVA team (SEVA are community development workers improving mental health and services for black and ethnic minority services in Manchester). SEVA can help user group gather evidence about people’s experiences. There is a lack of integration between health and social care in practice.
IL; Agree health and social care not integrated in Manchester. A large amount of money has gone into mental health services in recent years. The mental health National Service Framework (NSF) has a strong consensus behind it but in Manchester we are still behind. Still need to involve people in the process of change. The SHA has recognised the problems and now needs to get to grips with them.
• From the floor; The reinstatement of Karen Reissman would help build bridges.
IL; As a minister I cannot take a position on this.
• From the floor; Money spent on the SHA report could have been better spent (N.B. This was cited at £600,000 but later comment pointed out that this figure was for a report on services across the North West).
IL; It was a useful report.
• From the floor; There has been a systematic removal of user groups, especially those for black and ethnic minority communities, over the years. We need to strengthen them and have a structure for listening to user groups.
IL; The best user groups are independent and strong but are not best seen as adversaries of management. We need a fresh start in Manchester with users and managers working in partnership. We now have a blank sheet, let’s try to work together. Manchester has a history of adversarial relationships.
From the floor; This happens when you feel you are ignored. Need to move away from feelings of hurt and anger.
IL; There are really brilliant staff in the Trust doing a good job.
• From the floor; Staff should not be dismissed for voicing an opinion. I have heard staff say now that they don’t feel safe to voice an opinion.
Chairman; MUN campaigned for KR because it was in the interests of patients.
IL; Any successful organisation needs to have a voice for its staff. This is recommended in the recent NHS review by Lord Darzi. But staff cannot have a veto over change. Need to work together on necessary change.
From the floor; Recent reactions have arisen from extreme local circumstances.
Chairman; The power of veto by service users works in Holland. The most vulnerable people cannot speak for themselves, for example the users of Mainway as shown in the MUN report.
IL; I cannot consider individual services. We should not change things for the sake of it if services are of good quality. I will respond in writing to the MUN report.
From the floor; Change can be good but recent changes have meant a loss of services, nursing, day services. The Trust had no way to manage change. Most of us are terrified there could be further cuts. Need to look at management.
IL; Any successful organisation needs good management. We need to get some good leaders.
- • From the floor; What proposals do the Conservatives have for mental health?
IL; They have no proposals. In most parts of the country, the NSF has improved services.
Chairman; I speak by phone to users in other parts of the country and they say services are terrible.
IL; But there has been a high level of investment but in Manchester there has been poor management. My job is to ensure there will be good leadership in future.
- • From the floor; (Psychiatrist) Changes should have taken place in Manchester from 1999 and change here was not managed to ensure continuity of good services. Pearl unit is a good concept despite bad user experience. Trust management has been dysfunctional and the John Boyington report made some good and bold points. We should be able to trust in managers. Users should see this as an opportunity, not a threat.
• Secretary; Manchester Evening News journalist was presented with an award for work on mental health services. (Secretary presented Ivan Lewis with a collection of news cuttings).
• From the floor; (Manchester Alliance for Community Care) The John Boyington report does not deal with whether services are working effectively. Locally there are no well worked out corporate or strategic links with voluntary sector.
IL; The role of voluntary sector services is very important.
- • IL; I will feedback this meeting to the Strategic Health Authority.
Chairman; Thanks to Ivan Lewis for coming and listening. We hope we can work in partnership with the Trust in future.
- • Chairman; Jackie Daniel, the temporary chief executive of MMHSCT has been contacted. A meeting is being planned for 19th August at Mainway.
Next Manchester Users Network meeting will be on Wednesday 13th August at 10.30 at the User group Office.