According to an investigation by the doctors’ union, five million people do not have access to NHS mental health rehabilitation wards, meaning they are entirely reliant on out-of-area private sector care and can be left isolated from their families.
“At present, people with serious mental illness risk being treated as second-class citizens by the health service”
The research, carried out for the BMA’s magazine, revealed that NHS mental health rehabilitation wards have all but disappeared across 18 clinical commissioning groups (CCGs) and NHS trusts in England.
Using Freedom of Information requests to gather data, the BMA found that, out of 176 CCGs that responded, only 78 could provide figures on how much they spent on private sector care for the past three years.
For those that did, the figures showed a £21m increased spend on the private sector between 2016-17 and 2018, with an increase of just £2m for NHS providers.
The BMA noted that, while many trusts and CCGs were spending most of their budget on private providers of this type of care, some were spending all of it. Over the last three years these include:
- NHS Sandwell and West Birmingham CCG at a cost of £20.26m
- NHS Walsall CCG at a cost of £12.5m
- NHS East Lancashire CCG at a cost of £12.44m
- NHS Blackburn with Darwen CCG at a cost of £11.08m
- NHS Greater Preston CCG at a cost of £10.26m
As part of the research, the BMA also calculated travelling distances from a list of more than 2,600 rehab “out of area” beds commissioned by the NHS over the past three years. Of those that responded, 140 beds were more than a seven-hour round trip away.
Commenting on the figures, Royal College of Nursing professional lead for mental health, Catherine Gamble, said: “The NHS still hasn’t got to the point where people with mental health problems get the same access to care.
“They still await the same standards of care as people trying to get treatment for a physical health problem,” she said.
“At present, people with serious mental illness risk being treated as second-class citizens by the health service,” warned Ms Gamble. “We won’t close this gap until action replaces rhetoric.”
“Our members working in mental health understand that their patients deserve better than the situations outlined in this investigation in which people are kept far from home, friends and family,” she said.
BMA lead for mental health and a psychiatrist, Dr Andrew Molodynski, said: “This practice goes against the very nature of rehabilitation which should be a transitional process, helping to reintegrate a patient back into society.
“As seen in the cases of Whorlton Hall and Winterbourne, the ‘cut-off’ nature of these institutions can be a breeding ground for the development of harsh and abusive cultures. This has no place in modern mental healthcare,” he said.
Dr Molodynski said the “eye-watering sums” that were being spent on out-of-area private providers meant that the government “must get a grip of this worrying practice”.
“There are no positives here for patients, families, care services, or the public purse- quite the opposite,” he said.
“We need to ensure that care is available closer to home to give patients the best possible chance of recovery and reintegration,” he added.