Yesterday Manchester Parliamentary Candidates kindly answered the questions of Service Users. Yesterday the Manchester Press decided to ignore every family in Manchester, not one journalist from TV, Radio or the Manchester Evening News wished to report on six MP’s who’s story you can read below. Nick Clegg the Leader of the Lib Dems this week said he supported the Services Users and openly gave his support to The Trade Unionist and Socialist Coalition Parliamentary candidate Nurse Karen Reissmann who is standing against Sir Gerald Kaufman in Gorton, Manchester. Nick Clegg is a long time supporter of Manchester Users Network and Nurse Karen, who’s lucky number on the ballot paper is 7 (Seven) . Sir Gerald Kaufman says; patients should vote for him in Gorton, Sir Gerald Kaufman ,would not attend the M.U.N Election Special hosted by Manchester Users Network, his agent asked that patient’s talk to Sir Gerald, after the election . That’s a little late for us patients Sir, we need to know today how you are going to help the Mental Health Service Users of Manchester.”
By: Sue McPherson
Manchester Users Network ‘Election Special’ Question Time Report
Today, May 5th 2010, Manchester Users Network held an Election Special Question Time for staff, users and the public. It was a well-organised event held in the friendly venue of The Cleveland in Crumpsall.
MUN had invited a number of candidates to attend and it was pleasing to see some had accepted that invite in order to respond to questions about mental health– an area frequently under-prioritised in election campaigning. On the panel were Qassim Afzal, Liberal Democrat PPC for Manchester Gorton, James Edsberg, Conservative PPC for Blackley and Broughton, Caroline Healy, Conservative PPC for Manchester Gorton, Marc Ramsbottom, Liberal Democrat PPC for Manchester Central, Karen Reissmann, Trade Union and Socialist Coalition PPC for Manchester Gorton and Graham Stringer, Labour PPC for Blackley and Broughton.
A wonderful Question Time banner, made by school student Bobby Dowding, hung behind the candidates, and this contribution had been matched by an anonymous donation of ￡40 to support the meeting’s cost. The highly- skilled Chair, Paul Reed, having introduced the format – introductions, written questions and questions from the floor, asked the audience to take a minute’s silence to remember those MUN members not with us today. The questions were serious and excellent, covering both Manchester issues and wider points about mental health and the NHS.
Candidates were, in the main, well-prepared, though had different views on how mental health services and issues could be solved and contextualised in a wider backdrop of public sector cuts and their own party policies. There were also some challenges to each others’ political positions and some passionate points from the audience members. Paul Reed gave the candidates equal and ample time to give their answers and the meeting ran smoothly throughout.
The words fair, fairness and change cropped up many times – with the main parties, in particularly, using these phrases as an attachment to their approaches. A summary of some their answers gives a small flavour of the candidate’s views.
The first question asked how candidates would ensure that MUN groups could have a voice, given that Foundation Hospitals ‘personally select’ users to assess services?
The Conservative, James C. Edsberg, felt that how people have access to services was important and that consistency across the country was needed. They would address the issue of equal access to mental health services. Edsberg moved to a broader context, speaking of the ‘battle between Labour and the Tories,’ and that we needed a ‘clear result on Friday’ to make sure the NHS was not under threat. He added that there needed to be a better balance between the public and private sectors, contending that the private sector was a ‘wealth creator’ that supplied jobs. His colleague, Caroline Healy also mentioned the concept of the Big Society, arguing that the state could not provide everything. Lib Dems, Marc Ramsbottom and Qassim Afzal offered two points. Firstly, that users should be included in commissioning not just assessment of services and, secondly, that the Lib Dems favoured equality, fairness and empowerment. Karen Reissmann, TUSC, argued that trade unions elect their own representatives and the same should be true of users – they should be the determining voice. Nevertheless, she also remarked that people who speak out are often very vulnerable and are often afraid of any consequences of doing so – as such, she said, politicians have a serious responsibility to ensure they could speak out as they wished and must support them at every step. Graham Stringer, Labour, told us that if, in practice, discrimination existed then an MP would need to listen and take this up with the NHS – whether a Foundation hospital or not.
Question 2 posed this provocative point: would candidates consider holding a local referendum in the cases of sacked health workers who had been ‘honest’ about the NHS?
The Liberal Democrats and Conservatives said no, but felt that workers should be able to speak out; and that existing mechanisms, such as trade unions and tribunals assisted with that process. Reissmann contended that staff are not confident of speaking out about any problems in the NHS and that; for example, the Royal College of Nursing had reported that 67% of staff would not risk their livelihoods by speaking out. She spoke about the need for an open discussion by staff and users about the NHS without any ‘blocks’ or ‘fear.’ Stringer felt a referendum was a ‘bad idea’ and there were wider issues for the NHS. He believed people should be encouraged to expose problems, but the word ‘fear’ was too ‘glib’ a response from Reissmann.
Question 3 referred to how patients at Park House are being discharged, with debt, without access to a welfare rights officer. This service had been cut without consultation –would candidates support this service?
Reissmann declared yes, absolutely, she would support it – welfare rights officers should be a mandatory part of the service. The ‘myriad’ of benefits needed specialist and expertise support and that could only be done by a WRO. She said what was happening was a ‘disgrace’ as the service had been well-used in the past. She argued that a lack of access to such a service had the potential to put people who are unwell at risk. The Conservatives agreed in the main. Healy felt strongly that too many people were ‘tipped out’ of public services. She proposed that a better bridge between institutions and community are needed. Stringer added his approval, but remarked that it does not matter who provides the services, the state or the voluntary sector, while the Lib Dems felt that any elected MP should liaise with service providers, users and organisations to ensure full access to this service was given.
Then, an in-patient asked this: given suicide rates in Manchester had increased by 1/3rd over the last year, what changes in mental health services could help stop this dangerous situation?
The Conservative candidates prioritised reducing the stigma of mental illness, particularly in work settings. Edsberg argued that employers needed better training to ensure ‘fairness’ as many employees were worried they’d be passed over for promotion if they declared mental illness.
Afzal spoke about his work at the Roby Centre, the vitality of such services and further the need to address mental illness in the BME community. Ramsbottom pointed out the link between debt and suicide and the necessity of early intervention around access to support and benefits to help circumvent this problem. Stringer contended that other panellists were, however, ‘over-claiming’ what MPS can do. He proposed that statistics needed careful analysis in order to identify gaps in services and target accordingly, possibly introducing bespoke services where needed. Reissmann offered the point that suicide can occur when people feel hopeless about their future and that in spite of an increase to mental health funding, more was still needed. However, she argued that this needs to be matched by a deep consideration of the various contexts that create such despair – whether this is unemployment or the low level of benefits. She also pointed out that Labour had already announced nearly ￡1 billion worth of cuts to Greater Manchester NHS and that people need to band and work together to fight these cuts after the election.
Another questioner explained he was a ‘revolving patient’ and what did the parties’ manifestos say about guaranteeing Disability Living Allowance for the over 65s?
The Lib Dems replied that they had no plans to reduce any benefits but would have a review of public sector spending. They wanted to protect essential benefits and would use money earmarked for ID cards and a like-for like replacement of Trident, for example, as well as closing tax loopholes, to carry that pledge through. Stringer proposed that cuts were inevitable as there is a gap in the country’s finances. He did say, as a rejoinder to the Lib Dems, that he had voted against Trident and the Iraq war and had a very good record on these issues .He promised to fight to keep benefits as they are and provide pathways for employment
Healy said the Conservatives would be keeping Disability Living Allowance and would also offer a week’s respite for carers, who are often overlooked by the government. Reissmann recalled the 1980s when DLA was almost impossible to claim in terms of mental illness. She congratulated MUN on the way they had fought their corner to gain recognition. She argued that there appeared to be a systematic attack by government against people who are sick and a political choice about where to get money from, and who to give it to, was driving this attack. She contended that ￡130 billion went missing in unpaid taxes and loopholes, for example and it appeared the government would rather ‘bankrupt the working class than’ begin to fill the deficit by collecting those taxes.
The next questioner asked this: Could the panel discuss the idea that people in this country are not given recourse to public funds and services if their citizenship status was uncertain – and is this civilised?
Stringer said he had worked with Christian groups and had signed the Sanctuary Pledge. His conclusion was that the Asylum system was ‘inefficient’ and while his ‘instinct’ was to agree that the system was uncivilised he would have to say no: there were some ‘villains and worse’ in the system so citizenship needed granting first. Edsberg put forward the point that it was uncivilised because it took too long to determine status. He was very proud of the country being a ‘beacon of hope’ for asylum seekers but said the system was unfit for purpose. Reissmann argued that Asylum seekers are desperate, fleeing from countries like Iran, Afghanistan, the Congo and Iraq – often the trauma of persecution resulted in mental illness, which requires an immediate response. She pointed out there were political contradictions in policy that enabled our engagement with war in countries from which people were fleeing, while saying they were not fully welcome here; not only should we be giving proper recourse to services, but we should also allow asylum seekers to work. The Lib Dems agreed on this last point, arguing that this was a serious issue and that in a civilised society asylum seekers would not be dependent upon charity. Ramsbottom declared that the Tories were being inconsistent as they wanted to scrap the Human Rights Act. Healy rejoined this by remarking that the EU’s Common Asylum Policy, supported by Labour and the Lib Dems, means the UK has little say over Asylum polices.
Another questioner, a nurse said she was deeply worried about cuts after the election. She said in the NHS there was a saying that voting for the Tories would be like ‘Turkeys voting for Christmas’ but that ‘voting for Labour’ would be like’ voting or Easter – the cuts came a tad later’. What would candidates do to oppose cuts and privatisation in the NHS? Would the candidates pledge to keep beds – as people die without beds – and would they ensure NHS patients did not get ‘crumbs from the high table?’
The Conservatives responded by saying, firmly, that the Tories had made a pledge, unlike the other parties, in increase health spending and if we do not stick to it, ‘you can kick us out.’ An efficiency review would, however, need to take place. Stringer told us not to elect the Tories – and not to trust them. He told the nurse she had a ‘rum view’ given Labour had increased the NHS budget. He argued that it would be ‘absurd’ to promise a guarantee over bed numbers, as treatment needs and solutions were always changing. He said we had to accept some change and that not every hospital closure was a bad thing, given new hospitals such as the MRI had opened.
Reissmann said that Stringer was indeed right in terms of the amount of money put into the NHS, but argued that the market mechanisms introduced under Thatcher and increased under successive governments meant that such new hospitals were paid for through the Private Finance Initiative. She stressed that this costs significantly more than building hospitals through the NHS. The Lib Dems agreed with Stringer about positive change, but said that it should never be incumbent on individuals to campaign for the NHS. Democratic structures were needed in the service to ensure that users had a real say over changes or closures.
The last three points were raised and responded to in conjunction. One man reported that he had been shocked to receive a bill for ￡1000 after being in a care home on temporary basis – this, he said, had affected his health. Another was worried that the Department for Works and Pensions was ‘pushing’ people back to work and that ‘unqualified professionals’ were assessing users. Finally, another man reinforced the query about charges for social care, reminding the panel that 82% of users in Manchester had been landed with huge bills by the Local Authority. What will the candidates do, therefore, about the poor and the vulnerable in such situations?
Stringer said that care contracts should ‘speak upfront’ to users about the cost. He was already taking up the issue of charging with the Local Authority and while it seemed the legal basis was sound he did not think charges should have been introduced. In terms of benefits and the back-to-work agenda, he believed in a sensitive approach so that those who could work were fully supported. He remarked that sometimes ‘people are talked into feeling they are unfit for work’ and if they want to work they needed support to do so. The Conservatives proposed that money should travel with individuals and that they would end a separation of health and social care budgets, adding that it was not the ‘right ethos’ for Stringer to say the contract should have ‘spoken upfront to the user.’ In terms of work, the candidates said those that are able should be fully supported into work but if they cannot they should not be forced and that is ‘fairness’.
Reissmann argued that no charges should exist for ill people. The NHS and Social Care should not be run based on the ability to pay. She explained that there should indeed be a range of services in place to ensure those who wanted to work and could work were able to do so – but pointed out that being off sick can be a disciplinary offence. As such, those with mental health issues, who might have to take time off sick, need stronger employment rights – as, did all workers. She claimed that every ‘ounce’ was being squeezed out of public sector workers and thus here was another set of contradictory responses from candidates who had spoken so far: that mental health services were a priority, but that workers with mental health problems were simply not. The Liberal Democrats position was to ensure constituents were able to access MPs who would fight for their rights – and added that charges seemed ‘unfair.’ Employers should support those with mental illness and that the level of work taken by people must be appropriate to their capacity and fitness. Further, poorly managed local authorities, such as Manchester City Council, exacerbated the problem.
With questions over, candidates summarised their beliefs, policies and ideas. Stringer offered the continued improvement of the NHS as a sign of Labour’s commitment to mental health services. Ramsbottom, for the Lib Dems, said the principles of freedom, rights and liberty remained at the heart of his party’s approach. He would fight discrimination and ensure equality. Reissmann contended that mental health services and users were often forgotten and she would continue to add to her 30 years as an activist and nurse to work with others to fight that corner and fight back against the cuts. .The Conservatives ended by saying that real change could come if people voted for David Cameron’s party and that a new Tory government would address all the issues raised today; they would not pay lip services but ensure a better NHS.
There was no doubt that the candidates had faith in their own policies and approaches. Nevertheless, what did the MUN members think? Alan Hartman, a founding member of the MUN said he felt ‘Karen Reissmann would prioritise mental health the most.’ He said he was ‘disappointed that some candidates, such as Sir Gerald Kauffman had not come today’ and hoped that further hustings – vital for every election – would see candidates giving mental health a priority in their schedule. Alan also remarked that there did seem to be ‘cross-party agreement over the need for a welfare rights officer at Park House,’ which he thought was encouraging. However, he also said that MUN members had felt ‘intimidated’ because senior management from the Trust had appeared at this ‘political meeting to take notes.’ Politicians should take serious, serious note of Alan’s words and the shape of this Hustings. Some members could not come today because they are in-patients – yet rooms in hospitals are hard to book as service providers take up much space on a regular basis. When politicians talk about access and equality they might well want to think carefully about the resources needed to even begin to make that possible. They should also note that the word ‘intimidation’ stands in stark contrast to the frequent pledges of fairness. One thing is; The MUN understands, as a group, that it is their commitment that has raised and will continue to raise the deeply important debate about mental health in Manchester: politicians must match that commitment with more than words.