Liam Fox is the MP for North Somerset and a former Defence Secretary.
When I was running for the Conservative leadership in 2005, I made mental health one of my central issues and went so far as to launch my campaign at a community mental health facility in north London to reinforce the point.
One of my (now ex-) MP colleagues told me that, “I was going to vote for you but not if you are going to talk about things like that. It’s not what the public want to hear about.” So I applaud Nick Clegg for giving prominence to the issue in his conference speech.
It is no secret that I have huge differences with our coalition partners – I abhor their near-religious worship of the EU and shudder at their economic ineptitude – but they deserve real credit for raising the profile of this most appallingly neglected part of our health care system. It is an area where the Coalition has failed to take the opportunity to lead public opinion towards much needed reforms. The Lib Dems may rue their missed chance after May 2015.
One in three of us will come into contact with mental health problems in our lifetime, either personally or through a family member. From post-natal depression to Alzheimer’s to bipolar disorder, mental health problems can be hugely destructive to individuals and families if not adequately dealt with. Yet this whole area of medicine remains a Cinderella subject within the NHS. When services are under financial pressure this is one area that regularly gets squeezed, perhaps because those affected are less vocal than other patient groups. This is, in itself, a terrible indictment of our society. It is hard to imagine a cancer or cardiovascular problem affecting a third of the population being treated in this way. It is a national disgrace – one of the last great taboos we need to destroy.
There are three areas I believe we need to tackle – cultural, organisational and institutional.
Culturally, we could learn a great deal from our neighbours in Scandinavia where mental health problems carry no more stigma than, say, orthopaedic problems. I remember visiting a facility in Sweden which was light years away from many of the dreary and depressing units I had experienced in my own time as an NHS doctor – much more IKEA than Dickens.
Organisationally, we need to allocate mental health service funding from higher up the NHS chain or require commissioning bodies to provide minimum funding levels. I have long believed that issues relating to tertiary care, public health and mental health issues were unsuitable for local funding determination.
Institutionally, we need to recognise that the community care that has been promised for decades to compensate for the closure of the dreadful mental hospitals that existed in the past has simply not materialised. The net result is that some of the most vulnerable in our society have been moved from one unsuitable institution to another, often our prisons. Not only does this abandon them at a time of clinical need but it also clogs up our criminal justice system. Prison should be for criminals, not to hide the failures of NHS care. We need to return to the concept of sanctuary in new care facilities for those who are mentally unable to cope with the stresses of modern society and remember that asylum once had a very different connotation.
The challenges will increase not diminish in the years ahead. As a former defence secretary, for example, I am fully aware of issues such as PTSD which will need to be dealt with in the years ahead.
Reform of mental health care is one of the last great social reforms we need if we are to be a genuinely civilised society in the 21st century. It is a challenge that we must all accept, whatever our political allegiances.