Much has been written recently regarding the decision to transfer millions of confidential patient files. In a move which will come back to haunt the Coalition, the decision had become something of a cloak and dagger affair. Had the Coalition explained properly the reasons for their decision, the resistance would not have been so great. Caveat emptor!
The current Health Secretary has just announced a halt to the scheme pending a full investigation in to how the details of millions of people were about to be sold to health insurance companies. The former head of the Royal College of General Practitioners, Dr. Clare Gerada, was recently on the Today programme trying to justify the transfer of patient information. In doing so, she cited the thalidomide tragedy of the early 1960s. She patiently explained that the thalidomide legacy might have been drastically reduced had the then Government been privy to such large amounts of patient data. Reasonable enough on the face of it but there is still the small question of informed consent. Minor details for a Government in a hurry I realise...
Jeremy Hunt is the current Health Secretary and has done reasonably well when compared to one of his more well known predecesors. All things are relative. In 1960, the Tory Health Secretary in the Macmillan Government visited a small market town in North Wales - not usually the sort of venue to attract much media attention. His name was Enoch Powell and the town he visited was my home town of Denbigh. That day, he announced in a famous speech his intention to see a radical overhaul in the provision of mental health services. He wanted an end to the institutional Victorian lunatic asylums in favour of community care to augment the existing hospitals.
As Health Secretary, Enoch Powell had been decidedly unsympathetic to the mothers of thalidomide babies and won few admirers as a result. He stood as a Tory leadership contender in 1965 and garnered just 15 votes as Ted Heath won the day. While Heath would go on to win the General Election in 1970, Powell would become synonymous with his outspoken views on immigration. If his views on immigration were controversial, history would suggest that his views on the provision of mental health services was more so.
Just last week, more warnings were issued regarding the crisis in acute mental health services for young adults in this country. This problem has been deteriorating steadily as a succession of Governments have failed to recognise the absolute importance of mental health. As a town, Denbigh became synonymous with mental health services. Until the closure of the North Wales Hospital in 1995, Denbigh had provided care for the mentally ill of North Wales since it's inception in 1848. The announcement of Enoch Powell ensured that mental health beds in North Wales went from 1700 beds to care in the community literally overnight. In the 20 years since the hospital closure, it is hard to see whether things are better for the mentally ill of North Wales - or anywhere else in the UK.
It is not that I seek to defend the regimes of the former asylums because my research has revealed much that was wrong with them. That said, they also got a good deal right. Not least was the fact that the availabilty of bed space seldom became an issue. Generations of the same families found employment at the North Wales Hospital and Denbigh became something of a centre of excellence in that arena. In several mental health placements as a medical student, it is clear that the name of Denbigh is well known throughout psychiatric circles and not for the wrong reasons.
Whether or not this or the next Government is justified in seeking to gain access to your medical records is open to debate. Bed space provision for acute cases of mental illness is open to debate though. Enoch Powell was no stranger to controversy in his life and although he currently remains more synonymous with immigration, it might not be too long before he becomes rather more well known as the man who made life more challenging for the mentally ill. That would be an infinitely worse legacy because all health begins with mental health. One day, a Government will emerge with an understanding of this crucial area. I can but hope.
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