More On Mental Health Services In #Gwynedd.

There been a few news items over the last few days that I didn’t choose to blog about at the time, but I think that they are worth a mention, so I’ve decided to include them all here in one blog post.

Further information was released concerning the lady who’s body was found at Newry Beach (please see blog post ‘Another Death – Feb 13 2017’). It was revealed that she had been having a very hard time indeed, ‘was tired of fighting and just wanted to go to sleep’ and had lost possession of her children. There was also a reference to the staff from the NHS who had ‘cared’ for her. The police stated that there were no suspicious circumstances surrounding the death, so this sounds very much like the suicide of someone who had probably had contact with the mental health services.

Yesterday the Daily Post reported that a man was snatched from the jaws of death by a police officer – the man was sitting ‘cross-legged with his head bowed’ on the railway track at Connah’s Quay as a train approached http://www.dailypost.co.uk/news/north-wales-news/man-pulled-front-connahs-quay-12617717 I note that he’d told officers that he’d ‘had enough’. The state’s solution to this man’s problems was to prosecute him for trespassing on the railway line – he was fined £300 with additional costs. Is this not a little inconsistent with all the talk at present of ‘fighting stigma’, ‘asking for help’ and ‘talking about mental health’? This case is far from unique – I co-authored a book in 2012 with my friend Prof BJ Brown and whilst we were researching for this book we uncovered scores of examples of punitive responses by the legal system to people who had attempted suicide.

Then yesterday evening a reader of the blog brought this to my attention (after he’d finished crying with laughter himself) http://www.dailypost.co.uk/news/north-wales-news/psychologists-drafted-crack-wrexhams-arson-12621694 So north Wales’s own hopeless psychologists who have completely failed to provide any sort of decent mental health service for the region are now going to be called upon to ‘profile’ whoever might be setting fire to cars in Wrexham. We won’t expect any arsonists to be caught soon then. The Daily Post’s feature makes reference to the popular TV series ‘Cracker’, centred around a psychologist who advised the police. Although it was made clear at the time that there was no such Cracker figure working in the UK, this programme really caught the public’s imagination and was even the cause of an increase in applications to psychology degrees in the UK. (I wonder if the north Wales police noticed the irony that a TV programme suggested that they needed the advice of psychologists to carry out their job whereas in reality they were spending a considerable amount of time mopping up the mess left behind by the mental health services.) But then ‘Casualty’ in no way reflects what I’ve seen happening in A&E at Ysbyty Gwynedd when Stephen Gallagher has been on duty (please see blog post ‘Two Very Dishonest Dangerous Nurses’)…

Which brings me to the next item to be mentioned in this news round-up. Earlier on in the week, BBC News Wales reported on the ‘crisis’ in Wales’s A&E depts. The A&E depts of the hospitals managed by the Betsi were by far the worst performers.

There was a BBC news report stating that the NHS in Wales in the coming years would not cope without employing doctors who had trained outside of the UK. Well the medical services in north Wales for many years now have had such a bad reputation that home-grown graduates won’t work here – it’ll only be a matter of time before word gets around to non-UK graduates regarding how bad the situation is and they’ll stop applying for posts here as well. You can’t fool all of the people all of the time…

Lastly, this morning BBC News Wales is reporting that the Older People’s Commissioner for Wales, Sarah Rochira, is demanding evidence regarding the (alleged) decrease in the use of anti-psychotic drugs as a ‘chemical cosh’ in ‘care homes’ for elderly people, which she has described as a ‘national scandal’ http://www.bbc.co.uk/news/uk-wales-39006759 It is good to see that this is finally being addressed, but it would be good to see the irresponsible prescribing of anti-psychotics in the mental health services addressed as well. Some people do find that anti-psychotics help in some circumstances and some people find them a lot more helpful than the ‘talking treatments’ which are being so heavily promoted at present. However in the mental health services in north Wales, for the last thirty years anti-psychotics have been liberally dished out to patients by practitioners who have frequently ignored prescribing guidelines and have such little knowledge of, and rapport with, their patients that they would have been incapable of judging whether these patients were actually benefiting from these drugs. These drugs can have side-effects that pretty much stop people from functioning normally and can make them feel dreadful – I know of one Hergest patient who told a friend of mine that he could no longer live with the side-effects that these drugs were causing. He had previously tried to raise his concerns with the staff of the Hergest Unit and their response was to up the dose. (He was of course being forcibly injected with these drugs, so there was no escape for him.) He threw himself in front of a train a few hours after telling my friend how his ‘medication’ had destroyed his quality of life. And dear old Dr Raj Sambhi at the Heddfan Unit prescribes them to anyone who tells him that there’s neglect and abuse happening in the north Wales mental health services and that a paedophile ring was operating in the area.

http://www.drsallybaker.com/betsi-cadwaladr-university-health-board/news-round-up-feb-18-2017/

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The Story Behind A £1.5 Million Grant In Gwynedd.

Previous blog posts ‘Service User Involvement in North Wales’ and ‘We Control All The Outcomes’ describe how there is no effective or genuine representation for ‘services users’ and carers in north Wales and indeed never has been. If anyone at any time had ever ‘listened to’ a service user or carer the ‘services’ would simply not be in this state. For years, ‘service user involvement’ was left to completely ineffective bodies like the ‘Independent Advocacy Service’ or the ‘Gwynedd and Ynys Mon Users Forum’ (which were staffed and managed by people who were terrified of the staff and managers of the lethal services whom they were supposed to be holding to account), or Unllais (whom I knew were refusing to make representation regarding the mental health services even when they were being told of the most serious abuses). Until March 2016 Unllais held the contract for service user involvement in north Wales. Considering how hopeless Unllais had been at representing and involving service users, the ending of their contract would have been the most wonderful opportunity for the Betsi to begin some real ‘service user and carer involvement’. Readers will know that this never happened and instead a new nightmare is promised, as the ‘contract’ was subsequently given to CAIS/Hafal, who have now formed another vehicle, CANIAD (please see blog post ‘Introducing Caniad!’). So Dr Dafydd Alun Jones and Lucille Hughes, who sit on the Board of Trustees of CAIS, are now responsible for ‘service user involvement’ in north Wales. We can assume that the outcome from this will therefore be truly grim. Many of my previous blog posts describe the unethical and criminal behaviour of Dafydd Alun Jones – and Lucille Hughes was named in the Waterhouse Report as knowing that a paedophile ring was operating in Gwynedd Social Services whilst she was the Director of these ‘Services’ but that she was failing to act. Dafydd and Lucille are now in their eighties, they have never protected the interests of service users and carers before and I very much doubt that they are going to start now.

As soon as I heard that CAIS/Hafal had landed this ‘contract’ from the Betsi, I was interested to find out exactly how this had happened, particularly as there seems to massive conflicts of interest in many other ‘contracts for services’ being handed out by the Betsi. Blog post ‘A Total Lack of Transparency’ details how the whole process has been shrouded in secrecy.

So I recently put in a FoI request to Wrexham County Borough Council (who were inexplicably allowed by the Betsi to ‘lead’ on this whole travesty) in an attempt to find out exactly how CAIS had landed this contract and the identities of the people involved. Last week I received a reply from Wrexham Council which didn’t answer all my questions but did provide a lot of enlightening information. Wrexham Council told me that I wasn’t allowed to reproduce ‘copyrighted’ information without permission and although I’ve written to them requesting this permission I haven’t received a reply. So I cannot reproduce the wonderful information that I have been provided with in it’s entirety, but I can blog about the salient points within this information.

The first surprise that I got was how much this ‘contract’ was worth. It was worth 1.5 million. That’s right, the Betsi have channelled 1.5 million quid to Dafydd et al for five years worth of ‘service user involvement’. The Betsi are currently nearly bankrupting the Welsh Govt so bad is their financial position. But CAIS have been given 1.5 million. The information given to me also confirmed that a grand total of FOUR unidentified service users were ‘involved’ in this process. And I bet they won’t see much of the 1.5 million that has been handed over – indeed, I was sent a rather simplistic ‘presentation’ allegedly designed by one of the ‘service users’ regarding what ‘involvement’ means to him and he mentioned that he was able to claim his expenses. So he gets his bus fare and the price of a lunchtime sandwich reimbursed and Dafydd et al net 1.5 million.

The information provided told me that there were only two ‘bids’ put in for the ‘tender’, one from Unllais and one from CAIS/Hafal. The fact that ‘service user involvement’ was subject to a ‘tendering’ process alone excludes nearly all service users and carers. How many patients and carers are ever going to ‘bid for a contract’? How many even knew that all this was happening? I didn’t and I actually try to keep aware of what is going on in the mental health services in north Wales. But people on the ‘professional’ networks will have known all about it, because the information sent to me revealed that ‘from January 2014 onwards, the Health Board’s Commissioning Manager…attended all the Local Planning Groups in North Wales’. Well you won’t find many service users and carers in them, but ‘professionals’ know all about these planning groups, who sits on them and when they hold their meetings. It was also mentioned that the Commissioning Manager attended ‘Third Sector’ networks (CAIS is a Third Sector organisation) and Service User and Carer networks. Now in a region that was not blighted by corruption and criminal activity in the mental health services, the Commissioning Manager attending Service User and Carer Networks would be a positive sign. But in north Wales, most ‘service users’ experiences of the ‘services’ are so bad that when they finally wave goodbye to the services (if indeed they ever manage to obtain a service in the first place) they want no more to do with them. They do not join a ‘service user network’. Furthermore, in my experience the ‘service user networks’ in north Wales have always been manipulated or indeed completely controlled by the ‘services’ themselves or the lame third sector organisations such as MIND who have for years colluded with the abuses of the mental health services. And some of the service user groups are run by CAIS. So it’s highly unlikely that any grassroots service user and carer groups would have encountered the Commissioning Manager who was allegedly publicising the commissioning process.

But what if north Wales happened to have a really enterprising group of service users and carers who did know that a commissioning process was happening and who were even prepared to form a group to bid for this contract? Well the information provided to me suggests that they would have found such bidding very difficult indeed. For a start, the information regarding the bidding process and what needs to be done to land the bid successfully is littered with acronyms with are never explained. I have a PhD and a research background in social policy and sociology in the Welsh context and I didn’t know what most of those acronyms meant. But it gets worse. Even if a group of service users had managed to plough through all this and somehow decipher it, at the ‘Meet The Buyer Event’, in the ‘procurement information’, provided by Rachel Glynn-Thomas (‘category manager’) there was a reference to a preference for the bidders to make use of technology – specifically to submit the bid via e procurement, ‘utilising the Bravo Solutions etenderWales software hosted by the Welsh Government’. Well that will be familiar to every service user and carer in Wales won’t it, they’ll use it daily. Service users wanting to bid will have needed a good accountant as well, because they had to complete one of the most taxing spreadsheets that I’ve ever seen, worse even than the spreadsheets that I used to complete when I wrote research bids for the research councils that fund academic research (and I had the University accountant to help me). Now, even if our hypothetical service user group did contain a social policy expert, an accountant, someone who was familiar with procurement procedures used by the Welsh Govt as well as someone who knew how to install and use the specialised software used by the Welsh Govt for procurement, there was something interesting about when the ‘Meet The Buyer Event’ was held. I don’t remember seeing it being advertised anywhere. But if I was someone who might have been looking out for an opportunity to bid for a Welsh Government contract and was familiar with the procedure of bidding for these contracts, I’d have been looking at the website Sell2Wales. The contract was advertised on Sell2Wales – but not until nearly a month after the ‘Meet The Buyer Event’ had been held. So anyone attending that ‘Meet The Buyer Event’ (the only opportunity to receive information and ask questions) could have only known about it from an inside contact.

The ‘Meet The Buyer’ event was held in the Boardroom of Optic St Asaph, a location virtually impossible to get to by public transport – so interested service users who did know about it will have needed their own cars to get there. The people making up the panel at the ‘Meet The Buyer’ event included Wyn Thomas (Assistant Director, Community Partnership Development, BCUHB), Vicky Jones (Regional Substance Misuse Commissioning and Development Manager), Jane Jones (Partnership Manager, BCUHB), Rachel Glynn-Thomas (Category Manager, Wrexham Borough County Council) and Sion ap Glynn (Business Support Wales). These are not the sort of people that your average service user would know – but I bet people from CAIS knew them, particularly as CAIS already provide ‘substance misuse services’ on behalf of the Betsi and thus work ‘in partnership’ with them.

There were also two ‘service users’ on this panel, a David Holmes and an Andrea Hughes – however at least one of the powerpoints supplied to me allegedly presented by the ‘service users’ contained a number of highly complex flow charts. I have yet to meet a service user who would ever include such things in a presentation on ‘What Involvement Means To Me’. These managerialist flow charts were also noticeably inconsistent with the rest of the presentation material from the ‘service users’, which pivoted around claiming expenses, supporting others, feeling like a valuable human being, undertaking an entry level education course and no longer being sectioned. I suspect that the managerialist flow charts had been added to those presentations by someone else.

The information supplied to me also suggested that someone might have been expecting a bid from CAIS/Hafal. The information is littered with references to ‘substance misuse services’. Indeed mentions of ‘substance misuse services’ were being prioritised – again and again they were mentioned in the remit after ‘service user involvement’. But there are other rather big clues as well. One slide sent to me in response to my FoI request was a presentation by Jane Jones, Partnership Manager, BCUHB. She certainly seems to gearing up for a partnership with CAIS/Hafal – her presentation states that ‘we would welcome bids from a consortia or partnership but partners must be clear about their partnership arrangements before submitting an application’. No doubt Jane Jones wanted to ensure that any such partnerships contained the word ‘CAIS’ in their ‘arrangements’. The biggest clue however is contained on the slide prepared by Rachel Glynn-Thomas regarding ‘procurement information’: ‘WCBC [Wrexham County Borough Council] on behalf of the Six North Wales Authorities represented by the Area Planning Board for Substance Misuse and with the Betsi Cadwaladr University Health Board…’ So at the very heart of the ‘procurement process’ was the Area Planning Board For Substance Misuse – who are presumably the people who have already commissioned CAIS to provide ‘substance misuse services’ and know them well. Rachel’s slide mentions the need to ensure ‘best value’ and that a marketised commissioning process is the best way of achieving this – ah, so that’s how 1.5 million found its way into the pockets of Dafydd Alun Jones, Lucille Hughes et al…

The dirty deed has now been done, the dosh has gone to CAIS/Hafal and now Dafydd, Lucille and their mates are dictating what ‘service user involvement’ in north Wales looks like. One of the slides sent to me gives some ‘facts and figures’ regarding the region covered by the Betsi. It mentions that there are 1,600 staff employed in the Mental Health Division. So ‘service users’ who dare to complain are faced with 1,600 people sticking together like glue. (It’s tempting to suggest that there are probably more staff employed in the Mental Health Division than patients successfully obtaining a service.) And now they’ve got CAIS to represent their interests against the 1,600 people.

Whilst reading through the information supplied to me in response to my FoI request, any, many questions sprung to mind. But the biggest question of all surely has to be that if CAIS have been given 1.5 million for five years worth of ‘service user involvement’ how much are they raking in for providing all their other ‘services’? As Private Eye would say, I think we should be told…

http://www.drsallybaker.com/uncategorized/the-story-behind-1-5-million/

Services Denied…Again. #Autism #PDA

Down And (Nearly) Out In Gwynedd And London.

In 2008, I had a heart attack.
I had a stent inserted but during the operation I had a second heart attack and so another stent was needed.

My life until then had been spent working in the care field.
It began as a roving first aid responder at Heathrow Airport, then moved to caring for the elderly in a residential setting.
After a year working nights as a Care Assistant in a Nursing Home my nose took me into the field of mental health and dementia.
I found the work fascinating and heartbreaking due to the callous, profiteering nature of Care(!) Home providers.

I managed a sheltered housing scheme for 8 residents in East Sheen – which I hated.
Management  meant staying in an office, dealing with budgets, Doctors and social workers.

I moved on a lot back then.
Learning Difficulties, Challenging Behaviour and the most upsetting for me – Acquired Brain Injury.
Owners of Homes used me to clean sweep their businesses.
Each home was eager for my knowledge and ideas on dealing with ‘challenging’ clients and to train other carers.

Exploring other ideas I had meant working for Agencies where I lived in Clients homes.
24 hours a day, 7 days a week gave me even greater insights into the issues that my clients faced.
I chatted with neighbours of my clients, dispelling their fears and getting them onside.
I asked local businesses to help spend time with them and even give them some unpaid work.
All to get them out of the house and meet and engage with the community.
Exhausting and wonderful.

It transformed their lives and I hope transformed those who gave their time, cash and love to them.

The heart attacks meant an end to all that, sadly.

I discharged myself from hospital after three days.
For the first three months, I was crippled. Gasping for breath, my liver shut down and I turned an interesting shade of yellow.
My doctor was useless so I stopped going though I did continue to take 7 lots of medication for a year.

I was living in Islington at the time but it was isolating for me and expensive. Relying on savings meant I had to find alternative accommodation quickly.
An old friend kindly allowed me to stay in his flat in west London when he holidayed abroad. Another friend allowed me to sit in his workshop during the day to keep warm and even threw me some money and bought me food in return for answering the phone.

Soon I was offered other flat sitting opportunities and some people even paid me to protect their properties when they were away on business. A weekend here, a fortnight there – time passed and my health slowly improved.

One year after the heart attacks, my girlfriend was diagnosed with Breast cancer.
Never rains but pours eh ? Long weekends were spent at her place in Surrey

My girlfriend struggled through the chemotherapy and the rest of her treatment but, one year on, she was given the all clear. She had beaten cancer but our relationship had changed from lovers to carers for each other and we parted.

A year later and I began suffering other health problems. My breathing had never properly recovered and I developed many infections.My back and neck stiffened and caused me pain. My left hand began to hurt and I could no longer clench my fist. By this time, the Conservatives had been elected, London became meaner and many of my friends had left the city. I found myself struggling to find accommodation and work opportunities were drying up. Care work was no longer an option because of Insurance issues and my worsening health meant I was no longer reliable, even for the piecemeal work I sought.

Cutting my needs and relying more and more on my meagre savings I struggled on for another two years. During this time I met up with an ex partner who also was my oldest friend. She was living in Gwynedd, North Wales, with her autistic PDA son.

Social Services in the Gwynedd area are appalling. She has had no support and Bangor CAMHS refuse to acknowledge the boy has any mental health issues, at all. After one incident, in which the teenage boy used violence against her, I gritted my teeth and moved in with both of them. That was 18 months ago now.

All my years in Mental Health did not prepare me in anyway for PDA (Pathological Demand Avoidance). Within weeks my blood pressure went through the roof, chest pains, my heart rate became erratic. I ended up presenting myself at Shrewsbury A&E. (I have had experience of Ysbty Gwynedd and #BCUHB, who treated me after drinking contaminated water and, again when my partner miscarried our baby – it is my hope never to go there again). All the tests were good – well for a man with my cardiac issues and the Hospital put it down to stress.

I then signed on with the local Doctors Surgery and was given statins. Blood tests followed. The statin caused so much pain I could hardly move. A different statin and then Ramipril – more pain than before. I stopped the statin then realised it was the Ramipril. After nearly three months of pain and distress – I stopped the medication. My health improved – my stress levels did not.

The Doctor noticed something during an examination and ordered a Lung test. I failed and was diagnosed with COPD. I have not been back to see her since. My breathing has worsened this last year, blood pressure still too high but I need to be able to move quickly to deal effectively with the teenager and also my disabled partners needs are increasing as she ages.

The boy had recently been given four hours of support a week to aid with his social independence skills. Without warning or a re-assessment of his needs the hours were reduced to two – illegal in law. Take note anyone who has had their child’s support pulled.

The Support worker and Officer do not engage in any communication with us re the work they do with him. They refuse to give email addresses – no paper trail – do not give honest replies and are very evasive of communicating anything.  So unprofessional compared to the integrated planning around the client which I had been used to.

I believe my health issues are made worse by living in and dealing with the un-professionals in #Gwynedd. But without my support what will happen to the boy and my partner ?
In a few months my savings will be exhausted and what then ?