from: Healthcare Professionals Network | Guardian Professional:
We have become ever more used to hearing reports of a failing NHS in recent years. The NHS is becoming ever more politicised, and with it there are unseen and often unpredicted consequences for patients. While this makes providing compassionate and appropriate care more difficult across the health service, it is having a disproportionate effect upon care in mental health services in particular.
I have worked as a senior NHS psychotherapist, supervisor, manager – and also academic teacher to NHS staff. I am now clinical director of a private psychological therapy company as well as maintaining strong academic and NHS links. I can see the clinical differences between NHS and private approaches to care.
In recent times the effectiveness of mental health services has been reduced to how much a patient scores change on a range of blunt questionnaires about their mood that are often used incorrectly by clinicians and patients Greater emphasis is placed on these by politicians who incorrectly interpret what the data is saying. NHS mental health services are soon to have payment by results where their overall funding will be based on attempts to square the circle of subjective emotional experience into objective terms through flimsy questionnaire assessments. There is an obvious difference in patients that present to our private clinics compared with those in my NHS practice. Patients I have treated within the NHS paradoxically tend to have higher expectations of treatment than those in the private sector. I believe this is due to political over selling and heightening of expectations that patients are given of mental health treatments, to the point of being simply unrealistic. Ever greater targets have been introduced in order to try and combat perceived failings and NHS underperformance which produces great headlines but has also exacerbated the stress on mental health therapy staff and increases the gulf between Whitehall, patients and services.
I have first-hand experience of the numbers of clinicians seeking to leave the NHS and work privately – our business alone now has near weekly enquiries from excellent therapists and psychologists who are looking to leave the NHS for these reasons: indeed, all of our staff are ex-NHS. This affects NHS patients as more good staff seek to work privately creating serious consequences and leading to what is becoming obvious as a brain-drain of experienced NHS staff leaving more rapidly than ever before. This leaves increasing numbers of newer, inexperienced NHS staff treating ever more complex referrals with even greater expectations placed upon them and their teams.
The solution as I see it can only be a political one, but it won’t happen without pressure from NHS staff and the professional bodies within mental health. Government needs to adjust health policy to reflect the subjective nature of mental health; NHS commissioners should look to the private sector where patients are viewed more qualitatively as individuals rather than opportunities for statistics; and clinicians should think carefully about whether a private or NHS environment will allow them to provide their best level of care currently. I am aware of the difficulties of nationalised industries – indeed my current directorship in the private sector belies capitalist tendencies. However, with something as important as the NHS, a clear message needs to be sent to all that emotional health cannot be compared with physical health, and that NHS bashing disproportionately harms mental health patients in the NHS.
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