Volume 1

The regulation of private and other independent healthcare : fifth report / Health Committee.

  • Great Britain. Parliament. House of Commons. Health Committee.
Date:
1999
Catalogue details

Licence: Open Government Licence

Credit: The regulation of private and other independent healthcare : fifth report / Health Committee. Source: Wellcome Collection.

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    reflect clinical performance and will assist with the process of revalidation. MENTAL HEALTH SERVICES The nature of the sector 64. The number of premises and beds within the independent mental health sector has increased significantly over the last decade. The Royal College of Psychiatrists estimates that the sector now provides approximately 20% of all acute psychiatric care, 81% of all brain injury services, 30% of medium secure care, 44% of residential care for people with learning difficulties and 67% of beds for non-acute mental health care in registered mental nursing homes and residential homes.''* In 1997, the latest date for which official figures are available, 881 independent mental nursing homes accommodated 21,000 patients. Some 123 of these homes were registered to detain patients under the terms of the Mental Health Act 1983'! but the remainder accommodated many patients with some restriction on their freedom of movement. Many general nursing homes and residential homes also accommodate very large numbers of people who are, de facto, detained but not within the remit of the Mental Health Act, for example those suffering from severe dementia.'!® As an illustration, physical limitations might be placed on their mobility and there would be no formal avenue of complaint. 65. The provision of acute mental health treatment and care in the independent health care sector has a number of distinctive features when compared with services relating to physical treatment. As noted above, consultants working in the general specialties have access to hospital services through the award of practising privileges, enabling them to admit their patients and use the facilities of the hospital. The vast majority of such patients have an episode of treatment and have their costs paid through medical insurance. In contrast, the majority of consultants working in the 64 independent psychiatric hospitals are directly employed by the hospitals concerned and only a minority of patients in this sector are funded from medical insurance. A substantial number are funded by the NHS, having been referred from the NHS to specialist mental health services, either on a service agreement or individual contract basis. 66. Hospital treatment for mental illness may be undertaken on an informal basis or, where clinically necessary, the provisions of the Mental Health Act may be invoked to detain a patient in a hospital, which, in the independent health care sector will be registered as a mental nursing home under the Registered Homes Act and registered additionally by the health authority to accommodate detained patients. Depriving an individual of their liberty is a serious matter and protection of individual rights has to be safeguarded. It is important to reiterate that in the area of mental health care patients are extremely vulnerable.'!’ The mental health charity MIND told us they were concerned about standards of care in the private sector. In their memorandum they drew attention to the Mental Health Act Commission’s Seventh Biennial Report, which expressed its continuing concern over the comparatively large number of complaints received from private sector establishments.''* We agree with the view of Ms Caroline Quest of the IHA that “the mentally ill, however their service is being funded, should be entitled to Government assurance that the treatment they are getting is being regulated ... to an equal standard” irrespective of “from which sector they are coming or how they are being funded”.'”” 114 Bv., pl/y. 115 pane DoH Statistical Bulletin] 998/14, table 6c. 116 Q516. 7 Q415, NBs | Bcc nha 119 Q415.