The story below appeared in The Big Issue. Two years on the MunReporter invites it’s readers to read again this well reserch report by a well known and respected Northern journalist, Helen Clifton. With locked wards and despite all the promises made to patients about Mainway, it now seems those promises made to trusting service users account for nothing and staff say they fear for their patients.
Mental health patients in Manchester are
to be charged for attending day centres.
The council insists this is a fairer policy, but
health service users fear it could force them
away, leaving them even more isolated
and vulnerable. By: Helen Clifton.
Alan Valentine’s quiet, calm and unassuming manner totally contradicts the public perception of a man diagnosed with schizophrenia. But one subject has provoked some disquiet. Valentine, who is on incapacity benefit and disability living allowance, will soon face a bill for attending the Harpurhey Day Centre he has used for free for a decade. He could now be forced to drastically cut the number of hours he attends. “The new patients who need intensive care and a lot of groups will end up being fleeced of their benefits,” he says. Valentine, of Crumpsall, north Manchester, first arrived at Harpurhey ill and vulnerable after a period of hospitalisation. Eager to get better, he initially attended five days a week. He has since become much more stable, reduced his hours and now works as a volunteer chef at the centre’s men’s group. “It is very good,” he explains. “When I first started I went to as many groups as I possibly could. If I had to pay for each one of those in this present scheme, I would not have been able to afford it. “Now I have improved, and I only use one group. I feel like I have come on so much since then. It really is a great service for building up your confidence and mixing with other people. The staff are great. ” Despite his voluntary work, he will not be exempt a move he says effectively demands payment for working. “So many people will be struggling. It is more than likely that I will stop going so much,” he adds. Under Manchester City Council’s new fairer charging policy, launched last month, roughly a third of all adult social service users in Manchester will pay more. Previously, the city’s 186 mental health service users didn’t pay anything. But now, all those whose income is more than 45 per cent above the basic income support level will be charged. The only exemptions will be those released from hospital after being sectioned. The council is unable to say what the average cost will be. As well as Harpurhey, Victoria Park Day Centre and Hall Lane Adult Day Services in Wythenshawe will both be affected. The centres – funded by the Joint Commissioning Team, a partnership between the council and NHS Manchester – are located in three of Manchester’s most deprived wards. Valentine is one of around 100 members of the patient group Manchester User’s Network, who have launched a rigorous campaign against the policy. Some members, like bipolar Alan Shatsman, say they will stop taking their medication in protest. Many others, like Valentine, say they will no longer be able to afford the service. “It is not about what your needs are but what they say your needs are. If your needs are different to what the council say, you are in difficulty,” says Manchester Users Network chairman Alan Hartman, who has affective schizophrenia. “The day centres get people out of the house. Users talk to people with whom they have things in common. Without that day centre, they may become ill, they will become isolated and they are more likely to commit suicide. “One size doesn’t fit all. It is disgusting. They are ignoring users’ needs – they are not listening to the users of the services. They are not working in partnership because if they were we would know what is going on. We have got very vulnerable people at these centres.” Contrary to users’ claims, Caroline Marsh, director of adult social care for Manchester City Council, says nobody will lose their service. “We appreciate that this is a big change for mental health customers and we will be working closely with them to explain the process, so as to relieve their anxiety and make sure that they continue to receive the best possible care.” But life for Manchester’s many mental health patients is already difficult enough. Last year Manchester Mental Health and Social Care Trust was rated as weak and placed in the bottom ten of England’s 69 mental health trusts. They also faced months of industrial action following the sacking of nurse Karen Reissmann, and chief executive Sheila Foley resigned in October following the publication of a critical report. In a city with a suicide rate twice the national average, Hartman warns that charging can only make matters worse for beleaguered mental health workers. “It is going to put pressure on the teams. If people don’t take their medication, the risk of getting ill is very high. It’s very serious. “Manchester is different because they have got so many people with mental illnesses. One of the reasons the trust is rated so low is because they can’t cope. People will start self-medicating – they will start taking alcohol and using drugs.” The council says a survey of 42 local authorities – it doesn’t specify which – shows all but six now charge for mental health services. But neighbouring Bolton, Bury and Stockport councils don’t charge. According to Manchester Mental Health Watchdog, Salford City Council did introduce charges in 2003 but withdrew the policy “because the outcomes were so bad”. Manchester City Council is one of the last authorities in the country to introduce a fairer charging policy for adult social services based on individual budgets. The changes will result in an overall saving of £1.175 million a year to be reinvested in adult social services. The council claims it would be “discriminatory” to exclude mental health service users from the new policy. Yet according to Department of Health guidance, all authorities are free to use their discretion.
Highly critical of a three-month consultation on the policy, which finished in November, Hartman points out that the first his group heard of the decision was at a public meeting on March 23. Out of 3,880 consultation packs sent out to adult social care service users – and the many more made available at a number of events and council locations – only 31 were completed by those with mental health problems. Patient watchdog Manchester LINk says it wasn’t consulted. Angela Young, a member of Manchester Mental Health Watchdog who sits on Manchester City Council’s health scrutiny committee, says she has “serious concerns,” and has asked the council to reconsider the decision. “I feel that simply sending out a rather officially worded questionnaire to people is not an effective form of consultation. I regard it as an inadequate consultation. I don’t feel people are being informed properly. They have no idea about what they are going to be charged.
“One size doesn’t fit all. It is disgusting. They are ignoring Users’ needs – they are not listening to the Users.”
People are really confused. “Mental health users do need some special consideration. Maybe they should be exempt from being charged. Let’s do this with users and work to ensure it’s fair. “They call it a fairer charging policy. But it isn’t fair because of the way they’ve done it.” The policy may also have a knock-on effect on other voluntary services. One anonymous mental health worker says his project training volunteer mentors in day care centres now faces closure. He describes the decision as “shocking.” “It has left us pretty much up in the air. We don’t know how it is going to impact on the service and whether or not the volunteers are going to drop out. “The overall impact is that it is going to put users off, therefore it is going to impact on their mental health. They are not going to get out and about – they will become more isolated. If they stop visiting the day centres, people will not be there to tell if they are becoming unwell. “It is a catch-22 situation. Psychologists say users need to spend their money on certain activities. But now they say you need to pay for something else. People are disgusted. The day centres are run by the NHS – so why aren’t they free?”
The Manchester Users Network is holding a public meeting on 11 May from 2.00pm at the Therapy Centre, Park House Hospital, North Manchester General Hospital. For more information, call
Alan Hartman on 07719 102380.
In April 2008, Leeds City Councilintroduced a fair charging policyfor its adult social services. All users whose incomes are more than the basic income support level plus 25 per cent are now charged – a level lower then Manchester City Council. Saving over £13,500 are also taken into consideration. A year after introducing fairer charging, the council increased its rates. Home care increased its rates. Home care and supported living costs increased by 40p to £9.20 per hour; day services by 10p to £3.10 per hour; and the maximum weekly payment for home care £52 tp £140. The resulting income of around £2 millionper year is being reinvestedin a seven-day hot meals service, safeguarding service for vulnerable adults and extra support for carers. A public consultation in July 2008 included drop -in sessions, a telephone helpline and consultation with older and disabled people’s group. Over1,000 responses were received. Under the charges, those who use mental health day services are not charged.
This Article First Appeared In The Big Issue.
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