A duty of care

I am writing on the subject of mental illness, of which I have 40 years’ experience, all of it as a patient.

While psychiatric services have, generally, improved vastly since I had my initial breakdown in the early 1970s, there is one area of the system that has failed abysmally.

What I am referring to is a very small category of people who have fallen through the net of care in the community.

Since Enoch Powell, quite rightly, proposed the closing down of huge mental institutions, in the early 1960s, which were providing inadequate service to the mentally ill, much good has resulted from this policy.

However, there is a small group of service users (if I may use this term) who are quite incapable of living in the community because of a lack of the basic, necessary skills needed to do so.


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These unfortunates, irrespective of the support of CPNs (community psychiatric nurses), warden-controlled environments etc are unable to cope with ordinary, everyday tasks, in any capacity whatsoever.

They are farmed out to a broadly uncaring society and, consequently, end up as either the victims of an avaricious private sector or have to rely on family and friends to provide the necessary care – something that is beyond the scope of such carers.

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What is needed is a policy for this special group of psychiatric patients, which would afford them a satisfactory quality of life, independence to a certain degree and, at the same time, avoid the revolving door syndrome, which sees patients go in and out of hospital on a regular and frequent basis. There is nothing of this sort in existence in the NHS today.

Of course, this would, in turn, mean spending vast sums of public money (as we did bailing out errant banks) on such establishments, but, if the adage that the yardstick of a civilised society is judged by the means in which it treats its most vulnerable citizens, then we are compelled to find the necessary cash.

If we are seen to be a just, fair and caring people, then we have a duty to respond to the needs of the genuinely ill, as opposed to providing perks and tax cuts for the rich.

Nye Bevan would have wanted it that way.

David Woolgar

35 Burnside, Withycombe Raleigh.

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