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Issue #1830      July 11, 2018

Big profits in mental health

As the crisis in children and young people’s mental health services deepens during 70th anniversary celebrations of the National Health Service, Richard Branson’s Virgin health company has won £2 million in taxpayers’ cash in a legal settlement. Virgin sued an NHS trust after losing an £82 million contract bid. Virgin now runs NHS Devon’s child and adolescent mental health service (CAMHS), while CAMHS staff all over Britain are collapsing under the stress of increased demand for help from disturbed young people, especially during the school and university exam season.

Virgin Care won a record £1 billion of NHS contracts last year, as £3.1 billion of health services were privatised despite a government pledge to reduce the proportion of care provided by private companies.

Many of these contracts are for vulnerable children’s services.

Overall, private firms scooped 267 – almost 70 percent – of the 386 clinical contracts that were put out to tender in England during 2016-17. They included the seven highest-value contracts, worth £2.43bn between them, and 13 of the 20 most lucrative tenders.

Virgin’s £1 billion haul means it now has over 400 separate NHS contracts.

The £3.1 billion in contracts, a big rise on the previous year’s £2.4 billion, prompted concern that profit-driven companies are increasingly involved in delivering care, in a development that undermines repeated assurances by the Health Secretary Jeremy Hunt that they play only a marginal role.

Virgin Care pays no tax in Britain and its ultimate parent company, Virgin Group Holdings Ltd, is based in the British Virgin Islands tax haven.

The private sector’s £3.1 billion of wins last year represented 43 percent of the £7.2 billion of contracts tendered by the NHS for services, including babies’ health and out-of-hours GP care.

That dwarfed the £2.55 billion (35 percent) of tenders won by NHS trusts and £1.53 billion (21 percent) by not-for-profit organisations, including charities.

Recent figures from the Office for National Statistics highlighted a recent jump in the annual number of suicides among people aged 15 and over – 6,188 deaths in 2015, compared to 5,608 in 2010. An extra 580 suicides, over 10 per week.

Further analysis shows that the suicide rate “increased significantly” in the past few years from 11.1 deaths per 100,000 people to 11.8. For 15 to 19-year-olds there was an average of four suicides every week, while for 19 to 25-year-olds it was 14 per week.

Historic analysis shows that the total number of young people who killed themselves between 1981 and 2011 was 21,006 – over 700 a year.

The stats also show that during the peak years of unemployment – 1983-4, 1992-3 and 2009-10 – there were higher than average numbers of suicides among young people.

Youth unemployment is currently over 12 percent – well above the rate in Germany, the US, South Korea, the Netherlands and Canada.

The number of young people who kill themselves each year is a stark reminder of the human cost of government failure to invest in children’s wellbeing and prevent the onset of mental illness.

Suicide numbers are shocking enough, but there has been an exponential rise in CAMHS referrals for children and young people suffering from depression, anxiety, ADHD and self-harm during economic austerity.

Cuts to local authority budgets reduce preventative services, meaning vulnerable children are not getting help they need to stop their problems deepening and becoming harder to tackle in the long run.

Children who cannot get access to help and support early on will grow up to become troubled and unwell adults costing money, time and resources as well as potentially harming others or disrupting family relationships. If ever there was a false economy, this is one of the biggest and costliest.

While young people wait for help and support, teachers and parents or carers find they are on the front line trying to cope with dangerous and often frightening behaviour.

Suicide is now the second most common cause of death in young men and women in Britain, yet stigma and shame continue to blight those trying to cope and mental health is never politically popular.

Mental health used to be regarded as the Cinderella service of the NHS, with the least share of the total NHS budget. For those of us working in CAMHS we felt like the mice pulling the crystal coach.

As the crisis in CAMHS shows no signs of improving, the Tory strategy is clear as with every public service.

Run the service down with budget cuts, blame staff and managers for the inevitable problems and then shift the political narrative to enable the private sector and the likes of Richard Branson to swoop down and take over failing services.

It’s an old game and one that has to be resisted for our children’s sakes.

Steven Walker is former head of child and adolescent mental health at Anglia Ruskin University.

Morning Star

Next article – Nightmare of uncertainty

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