One cheer for NHS England

So NHS England have noticed that tier 4 CAMHS (the intensive inpatient service you need to go to when other levels of intervention have failed) is swamped, and NHS beds are like gold dust. Well done them!
One of the consequences of this surge in demand is an increasing reliance on private providers, and one of the things they may also have noticed is that inpatient private psychiatric care is the closest thing to a license to print money in the health sector. So in a sense the announcement of 50 more NHS beds is a cost control measure, but a sensible one.
They were also honest enough to say that they simply don’t know what future demand is likely to be. Partly this is because if supply increases people will request inpatient care more; at the moment everyone knows it’s near impossible so tries everything possible to avoid it. But the other reason is that demand for tier 4 services is driven by the fact that tiers 1-3 are falling into the sea, as a result of cuts.
In a final welcome fit of honesty NHS England observe that the way the NHS is structured has contributed to the problem. Too right, and at the heart of the mess of commissioners, local authorities, mental health and other trusts is…. NHS England.
For years the NHS had increasingly been run on transactions, governed by tariffs, and money has followed activity. This system in itself encourages division and competition, as organisations have no real incentive to cooperate, and patients are forced into artificial categories to suit the financial system they find themselves in, when of course their needs cut across any such boundaries.
Then last year NHS England, who set the tariffs, cut the mental health tariffs by 20% more than those for physical health. This was condemned by health minister Norman Lamb as “completely unacceptable” but even he couldn’t do anything about it because of the daft way they’d set things up.
So it’s great that a section of NHS England has noticed the festering sore that is CAMHS at present, and put a plaster on it. But 50 beds is laughable in the face of 850,000 children with mental health problems, and cuts to services by up to 40% since 2010. What they now need to do is walk down the corridor and bash heads together in the tariff department, before getting a cab to the DH and raising merry hell. Some chance.


One thought on “One cheer for NHS England

  1. Pingback: paedspoliticsbiscuits | The health select committee report on CAMHS: as good as it can be

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