I sent this letter today.

Dear Ms Hewitt,

As you appear to under the impression that the NHS is getting better and better, I thought I would bring the closure of specialist mental health physiotherapy services to your attention. I have helpfully cut and pasted the following from the Norfolk Eastern Daily Press. This is not a publication which sets the Government agenda (unlike such esteemed organs as the Sun and the News of the World), but it is highlighting a cut in what the government says is a priority area

Yes to staff, no to patients
MARK NICHOLLS

26 June 2006

A mental health trust covering central Norfolk has defended its decision to retain a physiotherapy service for its staff while axing a similar scheme for patients.

In a bid to cut costs as it endeavours to plug a £5.2m shortfall in funding, Norfolk and Waveney Mental Health Trust has come up with a number of schemes to save money, including the proposed closure of its physiotherapy department at Hellesdon Hospital.

Mental health patients, who relied on physiotherapy at the hospital with a specialist team skilled in dealing with such people, will now have to access general physio services through GPs and primary care trusts where they may face a lengthy wait of around 12 weeks.

Despite the cuts, the mental health trust has decided it is still cost- effective to keep a specialist physiotherapy service for its staff.

[snip perfectly reasonable explanation for keeping staff physiotherapy]

Mental health patients will now access physiotherapy through the same route as other patients, via their GP.

“The trust has taken this step because of financial reasons and cost pressures,” added the spokesman

Other cuts being considered by the trust include reducing the number of hot meals served each day, and ending free car parking and on-site hairdressing services for patients.

While the mental health trust has confirmed it is planning to close its physio service for patients in the next few weeks, primary care trusts say discussions are still continuing over how the physio for mental health patients will continue.

Clive Rennie, acting head of Joint Commissioning (Mental Health) at Norwich PCT, said: “We are currently in discussions with Norfolk and Waveney Mental Health Trust regarding cost savings to both parties. All options to achieve these savings are being considered, of which the physiotherapy service is one identified area. Discussions continue and a firm decision is anticipated by early July.”

The PCT says that as with other clinical services accessed via GP, the waiting time for community-based physiotherapy will depend on the severity of the problem.

In Norwich, the average wait for routine referrals is 12 weeks but those whose need is deemed urgent by their GP will usually be seen within two or three weeks.

This closure would result in patients with mental health problems being discriminated against. Patients requiring physiotherapy will have their needs met unless they have a mental health problem, in which case their needs will not be met. Mental health physiotherapy is a specialist service. Would you know what to do if a patient had a panic attack in your office? Would you know what not to do if a psychotic patient began to act upon his delusions in your presence? No, and nor would a general community physiotherapist. They can expect to experience those kinds of incidents a few times in their careers. Mental health physiotherapists deal with them every day. Treating a patient with back pain is one thing. Taking into account the anxieties she might have about uniforms, machinery, and even the way she is looked at is another thing altogether. No wonder general physiotherapists will treat the non-attendance (or other form of refusal) of a patient with mental health problems as a reason for discharge. In fact, non-attendance is a signal that something is going wrong.

I find it utterly reprehensible that the government will be funding ‘drop-in’ services for the working well, whilst a group that is already discriminated against in so many ways is being deprived of a vital service. As I’m sure you realise, these drop-in centres are lucrative cash cows for government-friendly private companies, pandering to those who aren’t ill enough or worried enough to take a day off to visit their GP. Patients with mental health problems don’t ‘drop in’ anywhere. They usually have to be coaxed.

More importantly, they aren’t vocal and they often don’t vote, so it is all too easy to pick on them. If this Labour government is serious about meeting the needs of the most vulnerable in society, now is the chance to prove it. It is time to recognise that the internal market you have created isn’t working, is obsessed with meaningless targets (does it matter if a time-waster with a cut finger waits for more than four hours in casualty?), and merely provides a get-out clause for the government – ‘it’s not us, it’s the Primary Care Trust’.

Your NHS ‘reforms’ and ‘modernisations’ are increasingly disadvantaging the most vulnerable in society: the elderly and the mentally ill. You must feel very proud.

Yours Sincerely,
Karen Field (ex-mental health physiotherapist, very ex-Labour Party member)