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Mental health

Ralf Littlte knocks Block off #Conservative #NHS Privatiser and Murdoch fan boy Jeremy Hunt #Mental Health #Derbyuk #Derbyshire #Derby

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120,000 DEATHS LINKED TO #Conservative #LibDems AUSTERITY #Derbyuk #Derbyshire #Labour #Momentum #DCFC

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The Conservatives have been accused of “economic murder” for austerity policies which a new study suggests have caused 120,000 deaths.

The paper found that there were 45,000 more deaths in the first four years of Tory-led efficiencies than would have been expected if funding had stayed at pre-election levels.

On this trajectory that could rise to nearly 200,000 excess deaths by the end of 2020, even with the extra funding that has been earmarked for public sector services this year. Real terms funding for health and social care fell under the Conservative-led Coalition Government in 2010, and the researchers conclude this “may have produced” the substantial increase in deaths. The paper identified that mortality rates in the UK had declined steadily from 2001 to 2010, but this reversed sharply with the death rate growing again after austerity came in. From this reversal the authors identified that 45,368 extra deaths occurred between 2010 and 2014, than would have been expected, although it stops short of calling them “avoidable”.

Based on those trends it predicted the next five years – from 2015 to 2020 – would account for 152,141 deaths – 100 a day – findings which one of the authors likened to “economic murder”.

The Government began relaxing austerity measures this year announcing the end of its cap on public sector pay rises and announcing an extra £1.3bn for social care in the Spring Budget. Over three years the additional funding for social care is expected to reach £2bn, which Labour leader Jeremy Corbyn said was “patching up a small part of the damage” wrought by £4.6bn cuts. The study, published in BMJ Open today, estimated that to return death rates to their pre-2010 levels spending would need to increase by £25.3bn. The Department of Health said “firm conclusions” cannot be drawn from this work, and independent academics warned the funding figures were “speculative”.

However local councils who have been struggling to fund care with slashed budgets urged the Government to consider the research seriously. Shadow Health Secretary Jonathan Ashworth said the Government must match Labour’s spending pledges in the Autumn Budget.

Per capita public health spending between 2001 and 2010 increased by 3.8 per cent a year, but in the first four years of the Coalition, increases were just 0.41 per cent, researchers from University College London found. In social care the annual budget increase collapsed from 2.20 per cent annually, to a decrease of 1.57 per cent. The researchers found this coincided with death rates which had decreased by around 0.77 per cent a year to 2010, beginning to increase again by 0.87 per cent a year.

And the majority of those were people reliant on social care, the paper says: “This is most likely because social care experienced greater relative spending constraints than healthcare.” It also notes that a drop in nurse numbers may have accounted for 10 per cent of deaths, concluding: “We have found that spending constraints since 2010, especially public expenditure on social care, may have produced a substantial mortality gap in England.”

The papers’ senior author and a researcher at UCL, Dr Ben Maruthappu, said that while the paper “can’t prove cause and effect” it shows an association. And he added this trend is seen elsewhere. “When you look at Portugal and other countries that have gone through austerity measures, they have found that health care provision gets worse and health care outcomes get worse,” he told The Independent. One of his co-author’s, Professor Lawrence King of the Applied Health Research Unit at Cambridge University, said it showed the damage caused by austerity

“It is now very clear that austerity does not promote growth or reduce deficits – it is bad economics, but good class politics,” he said. “This study shows it is also a public health disaster. It is not an exaggeration to call it economic murder.”

The Department of Health stressed that no such conclusion could be drawn. A spokesperson said: “As the researchers themselves note, this study cannot be used to draw any firm conclusions about the cause of excess deaths.

“The NHS is treating more people than ever before and funding is at record levels with an £8bn increase by 2020-21. We’ve also backed adult social care with £2bn investment and have 12,700 more doctors and 10,600 more nurses on our wards since May 2010.”

And independent academics added that it is hard to prove cause and effect with this kind of study even if the underlying assumptions may be correct.

Professor Martin Roland Emeritus Professor of Health Services Research, University of Cambridge said: “This study suggests that a change happened to cause deaths to stop declining around 2014. This is likely to be a correct finding. However, the link to health and social care spending is speculative as observational studies of this type can never prove cause and effect.”

Cllr Izzi Seccombe, chairman of the Local Government Association’s community wellbeing board, said: “We would urge government to review the evidence behind this analysis. If correct, it would clearly reinforce the desperate and urgent need to properly fund social care

Mr Ashworth, responding to the study, said: “This shocking mortality gap is a damning indictment of the dire impact which sustained Tory cuts to our NHS and social care services have had on health outcomes across the nation.

“Ahead of the Budget, this appalling news must serve as an urgent wake up call to the Prime Minister. She must match Labour’s pledge to deliver an extra £6 billion for our NHS across the next financial year to ensure the best possible quality of care is sustained for years to come.”

Get involved with the People’s Assembly today. 

2,000 people a month sent far from home for NHS mental health care

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Former health minister Norman Lamb attacks ‘discrimination at heart of NHS’ that in bed shortage prioritises patients with physical over mental health problems
Norman Lamb said out-of-area placements were an outrage.
Norman Lamb said out-of-area placements were an outrage. Photograph: Christopher Furlong/Getty Images

Of these, more than 500 end up as inpatients at least 30 miles from their home area, the Health and Social Care Information Centre data shows. This is despite such moves often causing great distress and increasing the risk of suicide among patients.

Campaigners said the figures showed that those with serious mental health problems suffered “complete discrimination” by the NHS that would never be tolerated for cancer or stroke patients.

“It’s an outrage what happens,” said Norman Lamb, the ex-health minister who obtained the figures and passed them to the Observer. “We know that out-of-area placements have a link to an increased risk of suicide. This would never, ever happen with a physical health problem, such as a stroke or heart failure. Why should we accept this for someone with acute mental illness, when we wouldn’t accept it for someone with cancer? It’s complete discrimination at the heart of the NHS.”

The figures show that in April – the first month such data was collected in a plan instigated by Lamb – 2,067 people were looked after as inpatients outside the area covered by their local mental health trust. By August, the figure was 2,198. The number of people sent more than 30 miles from their home area rose from 473 in April to 501 in August, the most recent month for which the HSCIC has released data.

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Vox Political:Sickness benefit medical test caused massive increase in mental illness, research shows

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Sickness benefit medical test caused massive increase in mental illness, research shows

sicknoteNew research has indicated that the work capability assessment – used by the government to decide whether a claimant should receive incapacity or disability benefits – may be causing mental illness among its patients.

The finding that the process is potentially harming its recipients has raised “major ethical issues” for all those involved, according to the report’s authors.

The research by Oxford University and Liverpool University shows that more than two-thirds of claimants who took the fake ‘medical’ test between 2010 and 2013 – 7,020 out of every 10,000 – received prescriptions for anti-depressant drugs afterwards.

There were 2,700 cases of mental ill-health and – most damning of all, six suicides per 10,000 assessments. If these were all separate cases, that would leave just 274 people who, after the assessment, were only suffering with the illnesses they took into it.

All the results were calculated after taking account of the impact of baseline deprivation, economic trends, and long-term trends in mental health.

More than a million people were reassessed for benefit using the WCA between 2010 and 2013 – in fact, using the figures from the study, around 1,306,670 people faced the assessment.

This means 590 of those people aren’t around anymore – they committed suicide and are dead.

If that doesn’t seem many, it should be remembered that suicide reached a13-year high in 2013, according to the Office for National Statistics.

Of the others, 279,000 were diagnosed with mental ill-health and 725,000 were prescribed anti-depressants.

This is equivalent to 5 per cent of the total number of suicides, 11 per cent of prevalent cases of self-reported mental health problems and 0.5 per cent of the total number of antidepressant items prescribed in England. And yes, all of these phenomena increased between 2010 and 2013.

The research also found that people who were reassessed were more likely to live in deprived areas – and the areas with the greatest number of people taking the WCA medical test had seen the sharpest rises in suicides, mental health issues and anti-depressant prescribing.

There is so much in the report that raises serious concern about the entire work capability assessment process. For example, it states: “Health professionals are involved in carrying out a large number of these assessments every year with a further one million assessments planned for 2015. Given that doctors and other health professional have professional and statutory duties to protect and promote the health of patients and the public, our evidence that this process is potentially harming the recipients of these assessments raises major ethical issues for those involved.

“Regulators and other bodies representing health professionals should advocate for the benefits and harms of alternative disability assessment policies to be established though a well-designed trial.”

The report states: “These test results suggest that the observed association between the reassessment process and mental health outcomes in the working-age population is not due to unobserved confounding” – in other words, the researchers believed they had ruled out the possibility of other, unseen, elements contributing to the results.

It adds: “We found that the level of reassessment in the previous time periodpredicted future increases in suicides, self-reported mental health problems and antidepressant prescribing.”

The experts concluded: “The programme of reassessing people on disability benefits using the Work Capability Assessment … may have had serious adverse consequences for mental health in England, which could outweigh any benefits that arise from moving people off disability benefits.”

They wrote: “We found that those local areas where a greater proportion of the population were exposed to the reassessment process experienced a greater increase in three adverse mental health outcomes—suicides, self-reported mental health problems and antidepressant prescribing.

“These associations were independent of baseline conditions in these areas, including baseline prevalence of benefit receipt, long-term time trends in these outcomes, economic trends and other characteristics associated with risk of mental ill-health.”

This is particularly damning: “These increases followed—rather than preceded—the reassessment process.”

You can imagine the DWP spokesperson’s response already, no doubt.

It will say that suicide and mental ill-health are due to multiple causes and should not be associated with a single element of a person’s life. It will also say that this evidence shows correlation, not causation – that is to say that there is no direct causal evidence linking the Conservative Government’s benefit policy with mental illness and suicide.

I say that is not true.

It is only a few days since This Blog revealed that the number of incapacity benefits claimants dying in mid-claim started to fall after the DWP suspended repeat work capability assessments for them in January 2014.

That data was released – reluctantly – in response to a freedom of information request I made almost a year and a half ago, under a threat that the DWP would be prosecuted for contempt of court if it did not comply. To use the government’s own rhetoric: If ministers had nothing to hide, why was this information not provided as soon as it became available?

And we have evidence from coroners, directly linking an increasing number of suicides with the work capability assessment and the DWP’s treatment of benefit claimants afterwards.

Circumstantial evidence, the DWP will say.

And that’s true.

But there are plenty of criminals serving long sentences behind bars because of circumstantial evidence like this.

I expect questions in Parliament. I would like to see a major police investigation into this entire policy area, looking at the cases of everybody who has died after being subjected to a WCA, the way they were treated by DWP representatives (including employees of the private companies that were hired to carry out the tests – Atos, between the dates used by the researchers), the politicians who put in place the policies that have been running between 2010 and the present and their reasons for ignoring the mountain of evidence against those policies, and the people who advocated the current regime in the first place, together with the evidence they used to support their case. Did they have any idea of the consequences?

But my inner pessimist believes all I’ll get are questions in Parliament.

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