And so it continues...
The weeks-long Twitter spat between Jeremy Hunt and Ralf Little opened its latest chapter on Monday afternoon as the Health Secretary launched a 26-tweet defence of his mental health strategy.
What began as a “double dare” from the actor over comments made about “the biggest expansion of mental health provision in Europe” has now reached box-set proportions.
WHAT HAVE I MISSED?
A recap of seasons 1 and 2 can be found here. But season 3 saw the Health Secretary “setting the record straight” and praising the “endurance and resilience” of anyone who read it, whilst also admitting that he is not funny.
There was even talk of season 4 being a live event.
SEASON 3 OVERVIEW
Hunt’s basic premise is that he is indeed overseeing “the biggest expansion of mental health provision in Europe”.
HOW DID HE DO THAT?
Hunt used a variety of reports and documents to backup his argument...
... but there were some issues.
PLOT HOLE #1 - The Correction
Hunt used a piece in The New York Times as evidence his approach to mental health was working.
There’s one slight problem - when this article was written it mistakenly asserted the “world’s most ambitious effort to treat depression, anxiety and other common mental illnesses” was treating one in three of the entire British adult population.
This is not true as a correction made after publication states:
Correction: August 29, 2017
An earlier version of this article incorrectly described the portion of adults in England who received treatment through the country’s free talk therapy program. One in three adults with common mental disorders have recently received treatment through the program, not one third of all adults.
So essentially he’s quoting a journalist who said he’s brilliant but the whole basis on which they said he was brilliant was based on a rather significant error.
And talking therapies aside, there are major ongoing issues with mental health provision.
A new report this month found access to mental health crisis care presents a “major issue” with 26% of people who try to contact support services not getting the help they need.
The Care Quality Commission’s (CQC) community mental health survey 2017, shows that access to crisis care has worsened since 2014 and “paints a picture of a service under pressure and users struggling, at times, to access the support they need”.
PLOT HOLE #2 - The ‘Mid Staffs’ Issue
The Mid Staffs scandal refers to the negligent deaths caused at Stafford Hospital between January 2005 and March 2009 which led to a public inquiry in 2010 and a number of recommendations being made for overhauling nursing care.
In tweet number seven, Hunt suggests a decrease in mental health nurses was caused by the plugging of understaffed wards.
Labour’s Luciana Berger told HuffPost UK: “Mid Staffs had nothing to do with the reason why all these people were cut from community mental health nursing.
“If you’re trained to be a mental health nurse you’re not transferable to go fill the wards to deal with patient safety to do with Mid Staffs, they’re not transferable skills.
“So the idea that the cuts to community mental health nurses of over 5,500 thousand suddenly plugged the gaps is just nonsense.”
PLOT HOLE #3 - WHY DO WE NEED MORE MENTAL HEALTH NURSES IN THE FIRST PLACE?
The main thrust of season 3 is that the Tories are doing much to train mental health practitioners and provide better services.
But what isn’t mentioned is that this is all in the context of huge reductions in the budgets of NHS mental health providers since the Tories came to power in 2010.
A Kings Fund analysis in 2015 found:
- Funding for mental health services has been cut in recent years. Our analysis shows that around 40 per cent of mental health trusts experienced reductions in income in 2013/14 and 2014/15.
- There is widespread evidence of poor-quality care. Only 14 per cent of patients say that they received appropriate care in a crisis, and there has been an increase in the number of patients who report a poor experience of community mental health care.
- These transformation programmes have also resulted in far-reaching changes to the mental health workforce and have led to a significant reduction in the number of experienced nurses. This has resulted in staff shortages and insufficient staff skill mix in some areas of care.
So effectively, the increase in mental health practitioners lauded by Hunt is to plug the gaps created by austerity.
This issue was raised in July when the Government announced an extra 10,000 more staff working in mental health treatment in England by 2020 without mentioning that 6,700 mental health nurses and doctors has already been cut.
Berger told HuffPost UK: “And that’s just within mental health, part of the NHS ‘envelope’ - that doesn’t take into consideration all the other cuts of people that haven’t been replaced in, whether it’s a children’s centre, befriending services, in outdoor spaces, leisure and recreation - all these things that make a difference to keep us mentally well.
“If you don’t have all those things then people turn up at the door of the NHS. So there’s a reduction of people at the NHS but that’s not even really shining a spotlight on the thousands of people we’ve lost all across the country that actually made a difference to keeping us proactively, positively and preventively mentally well.”
Ralf Little has yet to respond but we’ll update you as soon as he does - a few plot holes never stopped Jack Bauer from getting the job done.