Latest news with #HealthandSocialCareAct2012
Yahoo
19-05-2025
- Health
- Yahoo
There's no excuse for chopping down a thing of beauty. And I don't just mean the Sycamore Gap tree
I was moved to read of the grief expressed by so many at the brutal felling of the Sycamore Gap tree. I found it surprising. Not the crime itself: I know well the unconscious drive we all have within us to destroy good things – the most valuable, the most beautiful, the most life-affirming things. What took me by surprise was the capacity that so many people found within themselves to express their devastation and anger at this painful loss, not only to us as individuals, but as a nation. On the day the perpetrators were found guilty, I was reeling in my own private grief. I'd just read a different news story that told of another brutal cutting-down: again the destruction of something beautiful and valuable with deep roots, that stood for growth and possibility and life. The article, on this website, told how among other 'savings', talking therapies services are to be cut 'as part of efforts by England's 215 NHS trusts to comply with a 'financial reset''. As a patient in psychoanalysis that I pay for privately because I am privileged enough to be able to afford it; as a psychodynamic psychotherapist working in the NHS because I passionately believe that people should have access to good, sustained mental health treatment regardless of their means; and as your columnist writing about how to build a better life – I find this to be morally wrong. Just as I was not surprised by the felling of the Sycamore Gap tree, I am not surprised by these further cuts to talking therapy on the NHS. The flesh is so thin on the bone already, there is precious little now to cut, with patients facing the (bad) luck of the draw of patchy, postcode lottery-style provision. Many of us as individuals have a tendency to diminish our own mental anguish – to feel that physical pain is somehow more worthy. This is why it is unsurprising that we tolerate such meagre offerings of sustained psychotherapy on the NHS. It is why we have to have a law that mental health and physical health should be treated with parity of esteem – because deep down, we do not do this within ourselves. That law, incidentally, is the Health and Social Care Act 2012, which states it is the Secretary of State for Health's duty to 'continue the promotion of a comprehensive health service designed to secure improvement […] in the prevention, diagnosis and treatment of physical and mental illness'. How can he possibly fulfil this duty if the already limited offer of psychotherapy is reduced even further? Therapy allows people to stand tall when they have previously had to drag themselves along the ground Whether talking therapy services are scrapped altogether, or treatments are shortened and cheapened and replaced with 'interventions', it seems important to see the truth of what is happening here. There will be cuts to psychotherapy. Psychotherapy in its different modalities is a potent treatment that has been proven again and again, in study after study and in patient after patient, to be effective for many people suffering with mental illness – and, in the case of sustained psychodynamic psychotherapy, to grow more effective over time after treatment ends. Patients can use it and get better. Do we understand this? That psychotherapy works? Of course it doesn't always work, and it is not always indicated for everyone – like any other treatment. But for many, it works. It saves lives. It keeps people out of hospital. It enables people to get back into work. It can repair relationships. It can restore self-respect. It can allow people to stand tall when they have previously had to drag themselves along the ground. It is a treatment that works, and it is being cut, so people will have even less chance of being offered it than they do now. We need to find within ourselves the kind of anger and sadness at cutting down our mental health services that some have found within themselves at the cutting down of the Sycamore Gap tree. This tree found its home in an empty hollow and grew strong and true and beautiful. Psychotherapy can help people do that too. And what will fill the gap left when psychotherapy is cut down? The usual things people turn to when they are struggling and they feel hopeless, uncared-for and forgotten – none of them good. Suicidality; addiction; relationship and family breakdown. If we want to build a better life, for ourselves and our families and our fellow citizens, we need to do something about this. We need to fight for our cause; we need to protest in the streets and bring legal challenges and write (politely and firmly) to our MPs. We need to demand the Health Secretary fulfil his responsibilities outlined by the Health and Social Care Act 2012. We need to stand up and make it politically impossible for this government that talking therapies provision be further diminished; the NHS must offer psychotherapy treatment for anyone who needs it and who can use it. Receiving and offering psychotherapy has taught me that we all have it in us to cut down and destroy beautiful things – but we also have it in us to come together in our grief, to repair, to help each other, to do good things, to stand up when we see that something is deeply morally wrong. That is how we build a better life not only for ourselves but also for each other. • Moya Sarner is an NHS psychotherapist and the author of When I Grow Up – Conversations With Adults in Search of Adulthood • Do you have an opinion on the issues raised in this article? If you would like to submit a response of up to 300 words by email to be considered for publication in our section, please .
The Independent
14-04-2025
- Health
- The Independent
‘I was a newborn addicted to crystal meth and heroin – no one should have such a tough start to life'
It's hard to imagine a more difficult start to life than the early days of Callum Hesketh. He spent his first four months in intensive care after suffering a stroke and a cardiac arrest as hospital staff attempted to wean him off crystal meth and heroin – after he was born to a mother addicted to Class A drugs. Adopted at the age of four after 24 temporary placements in foster care, Mr Hesketh was raised by a loving family in St Helen's, and only discovered the true extent of his birth mother's condition as he became older. He had been born via emergency C-section over two months prematurely, and faced developmental delays during his early years, which included a diagnosis of Asperger's Syndrome. As a result of suffering a stroke, he has also had to undergo two squint correction surgeries, including one as recently as in 2020. 'My adoptive parents rewrote my story,' the 28-year-old told The Independent. 'They literally saved me. Children who are in foster care are sadly more likely to turn to those kinds of behaviours and turn to drugs because it's what they've been used to.' Latest figures reveal that over 1,000 newborns are born in England's hospitals every year suffering from neonatal abstinence syndrome (NAS), as they experience acute withdrawal symptoms from substances. Freedom of information data shows that nearly 12,600 cases have been recorded since 2014, placing enormous pressure on NHS staff as calls grow for increased spending on treatment and rehabilitation for pregnant women who present at hospital with addiction. Calling for better provisions to be in place for mothers who are struggling with addiction, Mr Hesketh said: 'This puts such a huge strain on the NHS, and they're not getting enough funding to help them and to provide recovery services. 'It needs to be enforced and there should be an action plan in place. It's currently not safeguarded, and in some cases you see a mother go on to have five children, all of them born with the same issues.' Statistics show that there has been a slight decrease in the number of babies being born with NAS over the last 10 years, down from 1,287 in 2014 to 1,001 between January and November 2024. Recent figures released by the Scottish Liberal Democrats revealed that over 1,500 babies had been born drug dependent in Scotland since 2017, as they called for further investment in local drug services. Symptoms can start within a few days of birth and can include uncontrollable trembling, sickness, poor weight gain and a continuous high-pitched cry. Consuming drugs and alcohol during the pregnancy can also lead to development issues for the foetus, and increases the risk of infections. The introduction of the Health and Social Care Act 2012 has seen drastic cuts to addiction services, as it removed their funding from the central government to being commissioned at the discretion of local authorities. With council budgets slashed over the last decade, services have been cut with less support available despite hospital admissions in England and Wales rising by 13.2 per cent between 2012 and 2021. Figures from the Office for National Statistics in October showed that the number of people dying as a result of drug poisoning had reached the highest level on record. 'Drug abuse is becoming a lot worse than it was when I was born in 1996,' Mr Hesketh told The Independent. 'I've got friends who work in a women's hospital, who say they just don't get the support and they're having to comfort babies who can't sleep or eat as they're dealing with addiction.' Now advocating for change, Mr Hesketh is calling for the government to introduce stronger measures to encourage pregnant women to break from the cycle of addiction. 'I was born into withdrawal and had to fight for my life before I even had a chance to live it,' he said. 'This law isn't about punishment — it's about prevention. We need to break the cycle of addiction, protect innocent babies, and give mothers the support they need to make better choices.' This includes mandatory addiction treatment which would involve free or low-cost programmes, financial aid, and housing support for pregnant women, with potential legal consequences for repeat offenders. Graeme Callander, policy and public affairs at addiction service WithYou, said: "It's vital that women who are using drugs during pregnancy receive the right support, for themselves and their child. 'Not enough research has been done on the impact of drug use in pregnancy on the child, and we also know that tragically stigma and shame mean many women are scared to reach out and ask for help. "Our services are free and non-judgemental. You can contact us by visiting our website at and by using our anonymous webchat service 9am-9pm on weekdays and 10am-4pm at the weekend."
The Independent
11-04-2025
- Health
- The Independent
‘I was born addicted to crystal meth and heroin'
It's hard to imagine a more difficult start to life than the early days of Callum Hesketh. He spent his first four months in intensive care after suffering a stroke and a cardiac arrest as hospital staff attempted to wean him off crystal meth and heroin – after he was born to a mother addicted to Class A drugs. Adopted at the age of four after 24 temporary placements in foster care, Mr Hesketh was raised by a loving family in St Helen's, and only discovered the true extent of his birth mother's condition as he became older. He had been born via emergency C-section over two months prematurely, and faced developmental delays during his early years, which included a diagnosis of Asperger's Syndrome. As a result of suffering a stroke, he has also had to undergo two squint correction surgeries, including one as recently as in 2020. 'My adoptive parents rewrote my story,' the 28-year-old told The Independent. 'They literally saved me. Children who are in foster care are sadly more likely to turn to those kinds of behaviours and turn to drugs because it's what they've been used to.' Latest figures reveal that over 1,000 newborns are born in England's hospitals every year suffering from neonatal abstinence syndrome (NAS), as they experience acute withdrawal symptoms from substances. Freedom of information data shows that nearly 12,600 cases have been recorded since 2014, placing enormous pressure on NHS staff as calls grow for increased spending on treatment and rehabilitation for pregnant women who present at hospital with addiction. Calling for better provisions to be in place for mothers who are struggling with addiction, Mr Hesketh said: 'This puts such a huge strain on the NHS, and they're not getting enough funding to help them and to provide recovery services. 'It needs to be enforced and there should be an action plan in place. It's currently not safeguarded, and in some cases you see a mother go on to have five children, all of them born with the same issues.' Statistics show that there has been a slight decrease in the number of babies being born with NAS over the last 10 years, down from 1,287 in 2014 to 1,001 between January and November 2024. Recent figures released by the Scottish Liberal Democrats revealed that over 1,500 babies had been born drug dependent in Scotland since 2017, as they called for further investment in local drug services. Symptoms can start within a few days of birth and can include uncontrollable trembling, sickness, poor weight gain and a continuous high-pitched cry. Consuming drugs and alcohol during the pregnancy can also lead to development issues for the foetus, and increases the risk of infections. The introduction of the Health and Social Care Act 2012 has seen drastic cuts to addiction services, as it removed their funding from the central government to being commissioned at the discretion of local authorities. With council budgets slashed over the last decade, services have been cut with less support available despite hospital admissions in England and Wales rising by 13.2 per cent between 2012 and 2021. Figures from the Office for National Statistics in October showed that the number of people dying as a result of drug poisoning had reached the highest level on record. 'Drug abuse is becoming a lot worse than it was when I was born in 1996,' Mr Hesketh told The Independent. 'I've got friends who work in a women's hospital, who say they just don't get the support and they're having to comfort babies who can't sleep or eat as they're dealing with addiction.' Now advocating for change, Mr Hesketh is calling for the government to introduce stronger measures to encourage pregnant women to break from the cycle of addiction. 'I was born into withdrawal and had to fight for my life before I even had a chance to live it,' he said. 'This law isn't about punishment — it's about prevention. We need to break the cycle of addiction, protect innocent babies, and give mothers the support they need to make better choices.' This includes mandatory addiction treatment which would involve free or low-cost programmes, financial aid, and housing support for pregnant women, with potential legal consequences for repeat offenders. Graeme Callander, policy and public affairs at addiction service WithYou, said: "It's vital that women who are using drugs during pregnancy receive the right support, for themselves and their child. 'Not enough research has been done on the impact of drug use in pregnancy on the child, and we also know that tragically stigma and shame mean many women are scared to reach out and ask for help. "Our services are free and non-judgemental. You can contact us by visiting our website at and by using our anonymous webchat service 9am-9pm on weekdays and 10am-4pm at the weekend."
The Guardian
14-03-2025
- Health
- The Guardian
What were the Lansley reforms and how did they create NHS England?
Keir Starmer announced on Thursday that the government was abolishing NHS England. Here we look at how and why the arms-length body was set up as part of reforms initiated by former Conservative health minister Andrew Lansley in an effort to improve decision-making in the health service. The changes introduced by Andrew Lansley, health secretary in the coalition government, represented the biggest reorganisation in the history of the NHS. One NHS leader quipped at the time that the overhaul was so big it was visible from space. Lansley promised that his Health and Social Care Act 2012 would take the politics out of the day-to-day running of the NHS. The act scrapped regional health authorities and shifted NHS commissioning power to GPs, through organisations later known as clinical commissioning groups. It also set up autonomous NHS organisations such as the NHS commissioning board, which later became known as NHS England, to run the service at arm's length from ministerial micromanagement. In addition, the act transferred responsibility for public health to local government. No, but they introduced what critics called a 'creeping privatisation' with a market-based system for more private involvement in healthcare. Under the banner of extending choice, Lansley's act allowed providers from the private and voluntary sectors to bid to supply NHS care. Critics claimed that handing budgets to GPs as independent contractors amounted to privatising the commissioning function of the NHS. They were almost universally criticised at the time, and there is now a general consensus they have been a disaster. Much of the criticism focused on the role of the private sector in the reforms. But experts also questioned the scale of changes at a time when budgets were being slashed under the austerity programme. The British Medical Association condemned the act as the 'end of the NHS as we know it'. In his critical review of the NHS for the Labour government, Lord Darzi pointed out that since the act public satisfaction with NHS has nosedived. Darzi described the Lansley reforms as a 'scorched earth' policy. The reforms caused widespread upheaval but also greater bureaucracy and duplication. In his last report, Lord Darzi complained that the NHS has been in 'constant flux' since the reforms. Darzi said: 'The instability of NHS structures and the multitude of workarounds and sticking plasters that became necessary as a result of the dysfunction of the Health and Social Care Act meant that NHS processes became fiendishly complicated. The Act divided up functions among a multiplicity of new institutions. In a single decade, NHS Improvement, the NHS Trust Development Authority, Health Education England, NHS X and NHS Digital were all created and abolished, with their functions and staff rolled into NHS England.' Critics also complain of less accountability due to the complexity of the system and the increased role of private providers. Yes, according to the health secretary, Wes Streeting. He claimed that 'the number of people working in the centre has more than doubled since 2010' referring to roles in both NHS England and the Department of Health and Social Care. The reforms also started a pattern of creating and then abolishing a number of NHS bodies, leading to more duplication and complexity. Many of the reforms have been chipped away or significantly modified. The Health and Care Act 2022 shifted the focus of the NHS from competition to collaboration with a scrapping of a markets-style economic regulator. It also scrapped GP-led clinical commissioning groups with integrated care boards to fund and plan NHS services. These included various NHS organisations and local councils. Under the 2022 act, NHS England was also given more commissioning power for primary care, dentistry and optometry. Despite these changes, private and voluntary sector organisations continued to be involved in providing NHS care. Only time will tell, but Streeting insists the move is 'the final nail in the coffin of the disastrous 2012 reorganisation'. He says that integrating NHS England into his department 'will put an end to the duplication resulting from two organisations doing the same job in a system currently holding staff back from delivering for patients.' However critics point out that, like the Lansley reforms, this latest upheaval comes against a backdrop of public spending cuts that threaten to undermine the good intentions behind the plans.
The Guardian
13-03-2025
- Health
- The Guardian
Streeting's ‘shock' at scale of NHS struggles inspires big political gamble
Since Labour won power last July, Keir Starmer has repeatedly affirmed his deep affection for the NHS, close family ties to it, intention to 'fix' it – and also his determination to change it. In a speech last September, he said the health service in England is in such dire straits that 'it's reform or die' and his government's plans to overhaul how it works 'could amount to the biggest reimagining of our NHS since its birth' in 1948. Wes Streeting, his high-profile health secretary, echoed that same cold-eyed message in his address to Labour's party conference two weeks later. The choice facing the country's most vital service was 'reform or die – we choose reform', he said. Beyond that bold rhetoric, however, Starmer and Streeting have – until now – given little in the way of concrete detail about exactly what that plan for reform will entail. The detail will be set out in a 10-year health plan, due in late May, which is being drawn up by Streeting and a coterie of advisers. It will put flesh on the bones of the 'three big shifts' in how healthcare is provided that both have promised: from an analogue to a digital service, from care in hospital to community-based care and from treating people's illness to preventing them from getting sick in the first place. But the biggest, most radical element of the plan is now in the public domain: abolition of NHS England, which the prime minister announced in a speech on Thursday about re-engineering the state. The executive body has run the health service in England since its creation in 2012, when it was handed independence from ministerial control and given responsibility for the operation of its 220 trusts, delivering treatment waiting times and making its ever-larger budget fit. Streeting is merging NHS England with his own department of health and social care (DHSC) and axing half of its 15,000 staff. The unexpected move amounts to a dramatic and brutal grabbing back of power that every health secretary since Andrew Lansley – whose controversial Health and Social Care Act 2012 spawned the now-doomed organisation – has wanted to do but never attempted, as Streeting pointedly reminded MPs in his Commons statement on Thursday. By deciding to abolish NHS England outright, rather than clip its wings, Streeting has marked himself out as the most radical health secretary since Lansley. Siva Anandaciva, the head of policy at the King's Fund health thinktank, says the move is 'a sudden and dramatic revolution in how the NHS is directed and managed. A radical reshaping of how the health service is led will [see] a seismic shift in power back towards ministers and government departments, who will have more control and direction over how the NHS operates.' The potential advantages to ministers should be less duplication between NHS England and the DHSC, quicker decision-making and more ministerial oversight of how the NHS operates, he adds Richard Sloggett, a DHSC special adviser under Matt Hancock, said: 'Like many other secretaries of state who have come before him in the post-Lansley era, Streeting has concluded he needs more power to deliver change in the NHS. But unlike those Conservatives who were reluctant to grab too much power, fearing the political fallout, Streeting haas concluded that a takeover of NHS England is possible and indeed necessary under a Labour government.' He sees the impending departures of most of NHS England's senior leaders such as its chief executive, Amanda Pritchard, its medical director, Prof Sir Stephen Powis, and the finance chief, Julian Kelly, as proof of 'Streeting's 'night of the long knives''. Given the huge number of dedicated, knowledgable NHS staff who will lose their jobs, it is unsurprising that others have likened the casualty count to blood-letting more reminiscent of ancient Rome or an episode of Game of Thrones. The abolition is also a mystery as well as a surprise. Streeting had previously, explicitly ruled out a reorganisation of the NHS. His planned reform would not need one, he insisted. Indeed, as recently as 30 January he ruled out reorganisation as a costly, complicated and politically challenging waste in an interview with the Health Service Journal (HSJ). 'My conclusion at this stage is that I could spend a hell of a lot of time in parliament and a hell of a lot of taxpayers' money changing some job titles, TUPEing over staff and changing some email addresses and not make a single difference to the patient interest.' He assured the HSJ that he would not get into legal scraps. He would simply do more to 'eliminate waste and duplication' across the two bodies. Yet he has now embarked on an undeniably massive reorganisation and one which he acknowledged will require legislation. The history of NHS-related legislation does not inspire confidence that the ensuing bill will proceed smoothly. There are other risks too: that the restructuring will prove a distraction, consume valuable energy and worsen morale among NHS staff among whom discontent is already widespread. So why take such a gamble? Those privy to his thinking say that, behind his respect for the NHS itself and those who have led it in recent years like Pritchard, he has become convinced that putting ministers back in charge – going back to the pre-2012 model – is the best way to ensure that Labour's ambitious plans, to 'fix' the service the most rely on most, can succeed. He has reached that conclusion after developing 'massive frustration' with what he sees as an apparent inability by NHS England's leadership to make meaningful progress in tackling persistent problems such as taking the pressure off hospitals and GPs by keeping more patients from needing emergency healthcare in the first place by looking after them better at home. Streeting, a driven, impatient character, has been left in 'shock' by what he has perceived to be a can't-do mentality among senior people who, when asked what their plans are to address key challenges, respond by stressing how difficult they are to fix. Starmer has pledged to get treatment waiting times back to where they were under the last Labour government and make the NHS work better in ways that patients notice. Both have to happen by the next general election in 2029, and both are huge tasks. Opinion polls show that nothing matters more to voters than the NHS. That absolute imperative seems to have persuaded Streeting, a who needs to visibly turn the NHS's performance around, to act so decisively, despite the cost and peril involved.
