Health Services (Gloucestershire)

I am inclined to agree with the hon. Gentleman, as he knows the statistics in his constituency. However, in some cases the percentage increase in drive time is worse in urban areas than in rural areas. Turning to adult mental health services, which deal with some of the most vulnerable members of my constituency. The loss of non-geriatric mental health services at the Charlton Lane centre in my constituency will be reflected in the loss of adult mental heath places overall in Gloucestershire. The mother of a girl who suffers from paranoid schizophrenia—I shall change her name to protect her identity—recently wrote to me: "““Younger patients, like Emily, will either go to an already existing hospital in Gloucester, whose beds will be heavily over-subscribed, or be…treated in their own homes by rapid response teams. These people cannot give the 24 hour treatment that Charlton Lane Centre gives, patients will be left in their homes to fend for themselves for much of the time. When Emily is poorly, the voices take over the whole of her thoughts and she is unable to cook, clean, shop or take proper care of herself. Those are the physical problems, added to these are the mental problems, the fear, the thought that someone will kill her is always very strong in her mind at these times, that is why she runs, to escape. The voices always tell her she is going to be killed, which in itself is a totally distressing and debilitating state of mind. There are lots of mental health sufferers in the community, but there are times that they can only properly be cared for on a 24 hour basis with properly trained staff in hospitals designed for this purpose. With this closure, there will be a chronic shortage of beds. I feel the Government and the Local Government will be letting down the most vulnerable section of our community with what is so obviously nothing more than a cost cutting exercise. A broken arm can mend at home once the patient has received the correct medical care, a broken mind requires a lot more care and attention if the patient is to survive.””" I could not have put it more eloquently. We need to consider whether the decision to provide more care in the community for mental health is the correct direction of travel. There is an argument for trying to encourage clients to be less reliant on institutional services, but surely that proposal, along with bed closures, should follow the successful implementation of community care. It is particularly brutal to close the service and hope that those vulnerable people will cope while it is withdrawn. There have been cuts in community nursing, health visitors and community palliative care, too. Surely, the Government should encourage such services in the new direction of travel, but I met nurses today who said that the implementation of the cuts had resulted in qualified district nurses being replaced by nursing auxiliaries. The mix of nurses in Cheltenham and Tewkesbury is 85 per cent. qualified and 15 per cent. unqualified nursing auxiliaries, but under the proposals, that will change to 50 per cent. qualified and 50 per cent. unqualified. Nurses will arrive in someone’s home in the community and find that they have complex health needs. Those nurses may be unable to cope, whereas in hospital they could ask a more senior or qualified nurse for assistance. A palliative care nurse told me that she was certain that there would be a big impact on the care provided to patients. The first community palliative care nurse post has been frozen, although the population is ageing and improved therapies mean that people spend longer in the palliative care phase of treatment. As a result, more care is needed, not less. Finally, there is a deep sense of injustice in Cheltenham at the loss of overnight children’s care at Battledown. The loss of that service is a stark illustration of the fact that, even though the clinical case was made for its retention, it was subject to a budget cut. A year ago, after a 27,000-signature petition and a £40,000 consultation, in which 98 per cent. of correspondence was in favour of the service, a recommendation was made to accept the clinical case for keeping overnight care at Battledown children’s ward, as 350 children a year would benefit. I pay tribute to Julie Coles, Carol Jones, David Downie and many others who campaigned tirelessly for the service. The recommendation resulted in the acceptance by all three primary care trusts in Gloucestershire that a nurse-led unit should proceed. The decision that overnight care should be saved was minuted—I have provided the Secretary of State with a copy—but it was overturned only weeks before the launch of the unit on the basis of cost. It was listed as a savings proposal, and thus the death knell was sounded for overnight care.