Published: 04/07/2002, Volume II2, No. 5812 Page 19
Now that 1 July has arrived and the NHS has entered the new era of patient choice - with the support of voters, according to a Mori poll which caught its sponsors, the in-conference British Medical Association, off-guard - was the government wise to plunge us all into NHS Week?
That modern media politics are a permanent campaign is certainly the conventional wisdom among politics junkies who adore Channel 4 import TheWest Wing.
That includes a clutch of Tony Blair's teenage advisers who love the idea that Number 10 is as glamorous and high-minded as President Bartlet's White House.
I am sure that down-to-northern-earth Alan Milburn and his team are not infected by such nonsense. 'If Jacqui Smith came from London - instead of the West Midlands - and belonged to the metropolitan in-crowd, she'd be famous by now, ' says one Londonbased admirer of the health minister.
NHS Week is about emphasising local options and empowerment, I am assured.
In any case, as we have noted here before, voters want NHS action, not more words.
And politicians must stop using patients as Punch and Judy fodder, says the BMA's Dr Ian Bogle, who might be wise to take his own advice. People feel over-spun all round.Which brings me to an aspect of current policy which seems to reflect well on the system and its capacity of altruism, the draft Mental Health Bill. Promoted as the 'no-spin' bill because it wasn't trailed (much) in advance, it is also said to be the first major look at provision since Enoch Powell's 'water towers speech' signalled the initial dismantling of the decaying Victorian network of asylums.
Bold claims both, they ignore the 1983 act that ushered in the drive towards care in the community, which last week's consensus fundamentally changes, to the alarm of many professionals, as HSJ reports.On the crucial issues in the bill, compulsory treatment in the community and indefinite detention of people with dangerous and severe - but not necessarily treatable - personality disorders, those divisions will remain during the promised three-month consultation.
July to September are not great consulting months, but the internet allows everyone instant access to those vital draft details, and newspaper letters pages are already lively.MPs debated the issue on day one because shadow health secretary Dr Liam Fox got wind of the imminent draft and switched the Tories' debate from crisis in care homes to mental health.
Rather than waste everyone's time, Minister Milburn brought publication forward and re-wrote his speech. There was some of the usual knock-about: which party is most to blame for past failure and whether Labour is providing enough extra cash to buy the NHS's Cinderella a proper new outfit for the ball. But the overall tone was constructive.Dr Fox had rehearsed his speech in newspapers and conferences, prompting health select committee chair David Hinchliffe to call it thoughtful, and the admired Ms Smith to detect a 'rare mood of contrition'.The shadow minister had admitted it was a rush 'too far, too fast' towards community care in the Tory 1980s. In his new caring mode he actually said sorry to those who had 'suffered unnecessarily'.
Concern was expressed all around about proper procedures to protect the rights of detainees and others in what is, after all, a relatively small, 'if horrific', problem.
Murders like Jonathan Zito's by Christopher Clunis are rare, despite the media hype.The consensus seemed to be that most mentally ill people are a threat mainly to themselves and should be helped by compulsory medication.
Will my right honourable friend acknowledge that government policy will have failed if the use of compulsion does not decrease in future, asked Lynne Jones, left-wing member for BirminghamSelly Oak.That is what we want, said Minister Milburn.
Patients whose first language is not English, but need to explain 'highly personal problems' in their mother tongue, need special safeguards, explained Plaid Cymru's Hywel Williams.
Everyone knows It is all tricky, but they should also know that voters are not so fearful of Clunis incidents that they want other people locked up and the key thrown away.
Call it altruism if you like, as with antipoverty or anti-racism policy. It is also hardnosed: the Wanless report said mental illness costs us£37bn a year, including 91 million lost working days. Plus crime.