NHS Tayside (Mental Health Services)

Part of the debate – in the Scottish Parliament on 9th May 2018.

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Photo of Lewis Macdonald Lewis Macdonald Labour

Everyone has acknowledged that we are having this debate because of failures in the provision of mental health services to the people of Dundee, Angus and Perth and Kinross. Those failures are to be the subject of the independent inquiry that was announced last week, and it is essential that the terms of reference of that inquiry are broadly drawn and that those who have been affected by the failures have a say in the process from the outset. The five principles that Anas Sarwar laid out today, and the cabinet secretary’s positive response to them, are very welcome.

The previous review of mental health services in Tayside led to decisions to cease to provide general adult psychiatry in either Perth or Angus. Those decisions, and the process of reaching them, must be looked at again as part of the new inquiry. At the time of the previous inquiry, the board’s view was that its existing model for delivery of

“acute admission inpatient services was not sustainable and could pose a significant clinical risk to patients and staff.”

As Jenny Marra said, its response was to close the Mulberry unit at Stracathro and to deliver those services only at the Carseview centre in Dundee. There needs to be reconsideration of whether that was the right answer and, if it was not, we must consider what else must be done to deliver safe and sustainable services.

We have already heard some of the concerns around Carseview, so I am glad that the remit of the independent inquiry will now go beyond that unit to look at mental health services across Tayside as a whole. Patients from neighbouring board areas may also be affected, because some specialised mental health services are planned and delivered on a regional basis.

Other boards are also involved, of course, with the chair of NHS Greater Glasgow and Clyde and the chief executive of NHS Grampian taking on equivalent roles for the time being in NHS Tayside. Although John Brown and Malcolm Wright certainly bring fresh pairs of eyes to the problems that will face them, they acknowledge that, for the planned inquiry to be credible, the appointment of a genuinely independent chair and advisers will be crucial. I welcome their plans to engage with the Mental Welfare Commission and others in seeking to identify the best people, and I look forward to hearing who will lead the inquiry, which I hope will be in the course of this week.

The inquiry must also provide a platform for those who have been most directly affected to have their voices heard. I join those who have paid tribute to the people who have attended the debate this afternoon. I know that patients and families do not just want to hear the answers; they want and need to be part of framing the questions. One constituent who contacted me yesterday evening put it succinctly when he said:

“I would like to know if I (and the rest of the general public) will be given the opportunity to provide evidence of the failures I have experienced through supporting friends who have been admitted” and

“if past and existing patients will also be given the opportunity to provide evidence”.

We know, since Grenfell, that the public demand to be part of the process, not simply its victims or beneficiaries, and that principle must apply here too.

I hope that one result of the inquiry will be to put in place clear clinical leadership and effective management of mental health services. Achieving that clarity can help to deliver the best possible mental health services in Tayside, including in particular the best hope of reducing the incidence of suicide. The Health and Sport Committee has agreed to take evidence on the Government’s suicide prevention strategy before the summer recess. Such evidence could influence the final form of the strategy if ministers are open to that.

Although the timescale is necessarily different, the independent inquiry in Tayside also has the potential to influence national policy on suicide prevention. If lessons can be learned from the experiences of families who have been affected in recent months, perhaps other families will be spared that pain. That is why those who have been affected must be at the front and centre of the inquiry. I look forward to NHS Tayside and ministers laying out exactly how that will be achieved.