A former health board chief has sparked fury by suggesting a landmark inquiry into mental health services should not have gone ahead because it held up work to improve care.
Crawford Reid, former chairman of the Perth and Kinross integrated joint board (IJB), believes the independent inquiry “completely screwed” plans to redesign local mental health facilities.
The inquiry, led by former prisons governor David Strang, strongly criticised what it described as a loss of “trust and respect” in local psychiatric services.
But Dr Reid believes the launch of the inquiry – at the behest of the bereaved families of suicide victims – has set progress back in Tayside by two years.
The redesign was signed off in January 2018 by Perth and Kinross IJB, which is in charge of inpatient mental health services, but was put on hold following the inquiry’s interim report in May last year.
Ahead of an NHS meeting to discuss a proposed action plan on mental health tomorrow (Thursday), Dr Reid said: “Several aspects of the inquiry report give me great concern. (Ex-chair and ex-chief executive) John Brown and Malcolm Wright came in at a time when Tayside was in a dysfunctional shape – it was a knee-jerk reaction.
“I’m not minimising how ruinous suicide is but what’s happened is the mental health transformation programme has been basically put on hold.
“If the transformation programme had started to move in, things would have improved with a full complement of consultants.
“They completely screwed it.”
Relatives of those who took their own lives after engaging with local mental health services have criticised Dr Reid’s comments as poorly considered.
“There have been ample opportunities for genuine change with regards to mental health services in Tayside over the years given the sheer volume of investigations and horror stories.
“Nothing was changing hence why I, and others campaigned for this inquiry.
“Perhaps if these fantastic changes that are being proposed had actually been implemented years ago, lives would have been saved and there would have been no need for an inquiry.”
She added: “I feel yet again that we, the bereaved families who campaigned tirelessly for change, are being used as a scapegoat for the never-ending list of failures.”
Mandy McLaren, who lost her son Dale Thomson to suicide in 2015, said: “The redesign was in the interim report, and it did say it should be halted.
“The matter with him is he doesn’t want to take any responsibility for the part they all played in allowing these failures and allowing these deaths.”
Following a near-two-year investigation, the Independent Inquiry issued 51 recommendations on February 5.
Witnesses who gave accounts to the inquiry described how the transformation programme appeared to be little more than an asset management plan to save money.
However, Dr Reid believes that, with time, the programme could have gradually reintroduced localised care at facilities such as the Mulberry Unit in Angus, which was mothballed in 2017 despite being only despite being opened in 2011.
He also believes independent case reviews should have been held for each person who dies after engaging with mental health services.
“If you look at each and every recommendation there’s not one that moves the process of improving mental health services in Tayside one inch forward,” he added.
“Not one of those 51 recommendations, without the transformation programme going on, will improve anything.
“The transformation programme had no time to bed in and move forward – if it had been allowed to develop the situation would have been fantastic compared to what it was two years ago.
“It’s not perfect but it’s far better than what we’ve been left with at this time. The sooner it gets put back on the boiler the better.
“Without a shadow of a doubt, this inquiry should not have gone ahead.”
NHS Tayside and the independent inquiry have been contacted for comment.
“We really need to work with staff to fix mental health”
Renewed calls have been made by NHS staff representatives for health bosses to work with them to improve mental health services in Tayside following the publication of the Strang report.
Jenny Alexander, employee director at NHS Tayside and a Unison rep, said the 51 recommendations were unlikely to be met unless staff were on board with the health board’s plans
She warned that actions could not be rushed through in the way the mental health transformation programme was perceived to be by some observers in 2018.
She told a meeting of Dundee’s health and social care partnership board (HSCP) yesterday: “The partnership aspect of this is very, very important.
“If we are running off and doing things like in 2018 we’re not going to do anything differently.
“We really need to start working in partnership with staff-side – if we don’t have staff on side we will never get through those 51 recommendations.
“We need to make sure we have improvements done for these people that we’re caring for.”
The independent inquiry found that staff reported feeling disrespected and undervalued by senior colleagues.
One mental health staffer described the atmosphere in mental health services as “a culture of fear”.
Arlene Mitchell, Dundee HSCP locality manager, says actions have already been taken in response to the inquiry.
These include the creation of new senior mental health posts, a new process for investigating adverse events and a plan to improve better support for those leaving mental health inpatient services.
Ms Mitchell said: “From a Dundee perspective, we’re in a good position…to ensure a strong staff partnership approach.
“We feel there’s a need to strengthen some of the staff partnership activity.”
The leader of Dundee City Council has responded to an independent inquiry into mental health services in Tayside.
John Alexander has today posted a statement on Facebook, stating that the capacity of the services “needs to increase” and that there are “too many people spread too thinly”.
An inquiry to examine the accessibility, safety, quality and standards of care provided by all mental health services in the region was commissioned after concerns were raised in the Scottish Parliament.
Mr Alexander wrote: “Last week in a 136-page document, Dr David Strang set out the results and recommendations stemming from the independent inquiry into mental health services in Tayside.
“I spent the weekend pouring over the entirety of the document, considering it’s contents and thinking about what kind of service could be provided if those 51 recommendations are adopted.
“It’s vital that each word on those page is taken in. It was hard hitting, honest and to be frank, painted a deeply worrying picture of where things were.
“Mental health and it’s impact on too many people is an issue very close to my heart, even closer more recently but it’s also something that isn’t talked about enough – between family members and friends. I spent my Sunday morning with friends and one of the things we were talking about was the battles with mental health.
“I defy anyone to find someone that doesn’t have a family member, friend or someone that they work with who hasn’t suffered from issues related to mental health.
“We need to continue to remove any stigma associated with it and support those who need support. There is of course, a wide spectrum and the impacts can often be unseen, sometimes until it’s too late.
“There continues to be a significant number of people in crisis, at the end of their tether and struggling to manage daily life. What this report says very strongly and clearly is that people have been let down by services in Tayside. What it also says is that going forward, the services must change.
“The bottom line for me is that the capacity of those services needs to increase. There are too many people spread too thinly and too many silos that don’t allow for sustained collaboration.
“The Chief Executive of NHS Tayside has, to his credit, apologised for those failings and has said that his “…personal commitment to the people of Tayside is that I will work with them to address all the recommendations made by Dr Strang in his report.”
“I’ve already discussed the matter with officers and look forward to meeting with NHS colleagues to see what actions have already been taken forward and hear how they intent to address the 51 recommendations.
“This report has been long anticipated and whilst I think there was a general expectation that there were issues, the fact that it has done such a thorough analysis and 1,500 interviews during that process should provide the evidence base required to make some big and necessary changes.”