Select Committee on Health Minutes of Evidence

Memorandum by MIND The Relationship between Health and Social Services


  1.  Consideration of structural change tackles only a small piece of the jigsaw which needs to be put together to provide responsive services. Reorganisation is not a panacea for inadequate resources or inappropriate service patterns.

  2.  The fundamental aim of any structure should be to deliver a package of services which address the range of needs experienced and expressed by people with mental distress including health, social care, employment, housing, leisure facilities and an adequate income.

  3.  Mind rejects major structural change such as the creation of a new Mental Health and Social Care Authority or single authority responsibility. There is a grave danger that these models could lead to a health or medically dominated approach to service provision and result in users' wider social needs being ignored. It could also threaten the current welcome diversity of provision.

  4.  Mind favours arrangements which allow for joint commissioning and the development of local joint plans for mental health whilst retaining the separate accountability of local and health authorities.

  5.  Effective user involvement through representation, stakeholder consultation, surveys and so on is essential whatever structure is adopted. The focus should be on working in an active partnership with service users and seeking to engage them with services which are acceptable and helpful to them.

  6.  Mind favours the development of national standards for mental health care developed in consultation with users and promulgated by the Department of Health.

  7.  Any change needs to focus on delivering services which are welcoming to and meet the needs of people from black and ethnic minorities and women.

  8.  Mind is concerned that there should be no extension of charging policies to mental health services which are currently free at the point of use.

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Prepared 10 August 1998