Oral - Michael Williams` Review of Mental Health Services

You will recall that, earlier in the year, in view of mounting concerns about the consistency, quality and availability of mental health services in Wales, I informed Members that I would look again at the way in which mental health services were planned and managed. Following discussions with the Wales Alliance for Mental Health, I asked Professor Michael Williams, now vice-chair of Abertawe Bro Morgannwg University NHS Trust, to provide me with a first view, as an independent but informed observer, on the best method of planning and delivering mental health services in Wales. I have now received his report.

I welcome the document as an important contribution to the journey on which we have embarked in relation to mental health services in Wales. I am determined that we lead a substantial, national debate on these vital services. One reason why the mental health service has so regularly been referred to as a cinderella service is the failure to make it the subject of open, public deliberation. Services that are out of sight are, as Members will know, very quickly out of mind. Professor Williams’s report will help to ensure that we shine a new light of public interest and attention on the future of mental health services, and I am very grateful to him for that.

Professor Williams sets out in his report the approach that he has adopted and the evidence that he has considered. In particular, he has worked with Hafal and MIND Cymru on developing his recommendations. His report draws heavily on the recently completed all-Wales review of mental health services, jointly chaired by Mary Burrows, the chief executive of the North East Wales NHS Trust, and Stewart Greenwell, chief officer of social care and housing in Torfaen County Borough Council. The Burrows/Greenwell review took a wider look at the issues affecting the effective delivery of mental health services in Wales, and made recommendations regarding the planning and delivery of mental health services. It was, however, undertaken prior to my decision to consult on the wider NHS structure in Wales, and Professor Williams has been able to reach his conclusions in the full knowledge of the consultative proposals.

We all understand that good mental health and wellbeing is crucial to the quality of life of individuals, families and the wider community. Taking steps to improve and protect the mental health and wellbeing of all people in Wales is one of my key priorities, and I recognise the critical role that mental health and wellbeing plays in the development of a socially cohesive and economically vibrant country. By taking the right action, we can avoid the considerable personal, social and economic costs associated with avoidable mental health problems.

In developing his recommendations, Professor Williams has paid particular attention to the work of the World Health Organization. Its key messages are that health and mental health are closely related; mental health is the basis of wellbeing and is vital to society, families and individuals; it is influenced by socioeconomic and environmental factors; it is linked to behaviour; it can be enhanced by effective public health interventions; and it may depend on shared values as much as the quality of scientific evidence. A climate that respects and protects basic civil, political, economic, social and cultural rights is fundamental to the promotion of mental health, and intersectoral linkage is the key for mental health promotion. Mental health is everybody’s business. I think that all would concur with that.

To strengthen our ability to improve mental health and wellbeing in our communities, Professor Williams recommends that a single, responsible statutory body be established to plan and deliver a fully integrated mental health service. He also recognises the requirement that any such body would have to develop mechanisms that are more local to ensure the joined-up delivery of services on the ground. Professor Williams considers that such a body will emphasise the positive benefits of addressing issues of wellbeing throughout life. The body would need to unite primary care, community mental health services, social services and acute services to provide seamless care for users. Most importantly, care should not be adversely affected by matters of organisational boundaries, age or budget. Professor Williams recognises the importance of primary and specialised mental health services working in close partnership with the provision of general health services for people who have mental health problems, regardless of the setting in which support and care is offered. His report highlights the need for strong and effective liaison services to be further developed.

Professor Williams envisages a body that would provide a comprehensive service combining the expertise of national health service trusts and social services, with a firm commitment to work with primary care, voluntary organisations, private and not-for-profit providers, and bodies in areas related to health, justice, housing, education, leisure and the arts, driven by the needs of service users and their carers, with sound clinical leadership, expertise and commitment. He also advocates a stronger focus on research, development and teaching within mental health services to ensure that future needs, as well as current needs, are met.

I circulated Professor Williams’s report to all Members earlier today to add to the wider debate on mental health services. That debate will need to take account of the NHS structural reform consultation that I launched at the beginning of May. I shall be seeking the views of all stakeholders, including patients and their carers, on today’s report to inform my thinking on these important matters. I am determined to ensure that, in reaching any conclusions, I achieve a model for the management of mental health services in Wales that meets our requirements now and in the future, and that these arrangements are consistent with the overall model for the organisation of health and social care in Wales. I look forward to receiving the views of all those interested in this vital area.