The switch to digital

Digi-geeks and stubborn luddites

 

Today, BBC Two is switched off in transmissions in the London area, thus marking the beginning of the end for analogue television in the UK. The switchover has been a long time coming – it was originally planned to be complete in 2010, but was delayed by two years to enable discussions to take place about what to do with the spectrum after it is freed-up. But now, it is finally upon us. By September this year, all anologue transmissions in Great Britain will have been ended. A month later, Northern Ireland will follow suit.

The point of the switchover isn't just to ensure that stubborn luddites upgrade their TVs and freeview tuners, nor is it a devious plan to deprive the rural parts of the country of their basic human right to four quality TV channels and Richard Desmond's Five (although it will have both of those effects). It's also crucial to keeping Britain vaguely near the cutting edge of communications technology – and to letting early adopters use their new iPads.

A minor science lesson: Pretty much everything that communicates without wires does so using the radio spectrum. That includes radios, of course, but also TVs, mobile phones, computers using wi-fi or bluetooth, controllers for your Wii, and certain hi-tech pacemakers. The only real exceptions are remote controls, which largely use infra-red (still an electromagnetic wave, mind you). Each of these devices uses a different part of the radio spectrum. Some, like wi-fi, use one that doesn't travel very far, but can carry a lot of information; others, like radio, especially longwave radio, can't carry much at all, but can picked up hundreds or even thousands of miles away from the transmitter.

In a sweet spot in the middle of this is the part of the spectrum used to carry analogue TV signal. It's clear enough to carry video signals, even using 1960s technology, but it is still long range enough that all of London can be served from one aerial in Crystal Palace. Which is why its a bit of a waste that it's being used to deliver Jeremy Kyle and Doctors to the few houses that haven't yet upgraded.

When the signal is switched off nationwide, Ofcom will get to the business of auctioning off that space on the spectrum to interested parties. They will be hoping to hit payola; the last time there was a major auction for bandwidth was the tail-end of the dot-com boom, when the 3G spectrum was sold for £22.5bn by Gordon Brown.

For a number of reasons, the new auction is unlikely to raise that much. The telecommunications companies have learned their lesson, for one, and now have a more realistic appraisal of the importance of the technological cutting edge when it comes to generating revenue. In addition, the way that auction was run (it was held as a limited licence sealed bid auction, which means that the bidders don't know what the others are bidding, and there are fewer slots than bidders) was specifically designed to raise as much revenue as possible, and is seen as partially responsible for the loss of up to 30,000 jobs as the buyers struggled to recoup the money they had spent.

Even so, the phone networks are still eager to get hold of some of the bandwidth – specifically, the 800Mhz spectrum, which is earmarked for LTE networking, also known as 4G. This was one of the headline features of the new iPad, but due to the sloth with which Britain has freed up the space, we won't be able to turn it on until mid to late 2013, after such digital luminaries as Armenia and Uzbekistan.

Forget pensions, tuition fees and EMA. The real war of the generations is that we haven't booted the elderly off their analogue tellies quick enough to get nationwide 4G before the iPhone 5 gets released.

 

How to upgrade, Getty images

Alex Hern is a technology reporter for the Guardian. He was formerly staff writer at the New Statesman. You should follow Alex on Twitter.

Photo: Getty Images
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British mental health is in crisis

The headlines about "parity of esteem" between mental and physical health remain just that, warns Benedict Cooper. 

I don’t need to look very far to find the little black marks on this government’s mental health record. Just down the road, in fact. A short bus journey away from my flat in Nottingham is the Queens Medical Centre, once the largest hospital in Europe, now an embattled giant.

Not only has the QMC’s formerly world-renowned dermatology service been reduced to a nub since private provider Circle took over – but that’s for another day – it has lost two whole mental health wards in the past year. Add this to the closure of two more wards on the other side of town at the City Hospital, the closure of the Enright Close rehabilitation centre in Newark, plus two more centres proposed for closure in the imminent future, and you’re left with a city already with half as many inpatient mental health beds as it had a year ago and some very concerned citizens.

Not that Nottingham is alone - anything but. Over 2,100 mental health beds had been closed in England between April 2011 and last summer. Everywhere you go there are wards being shuttered; patients are being forced to travel hundreds of miles to get treatment in wards often well over-capacity, incidents of violence against mental health workers is increasing, police officers are becoming de facto frontline mental health crisis teams, and cuts to community services’ budgets are piling the pressure on sufferers and staff alike.

It’s particularly twisted when you think back to solemn promises from on high to work towards “parity of esteem” for mental health – i.e. that it should be held in equal regard as, say, cancer in terms of seriousness and resources. But that’s becoming one of those useful hollow axioms somehow totally disconnected from reality.

NHS England boss Simon Stevens hails the plan of “injecting purchasing power into mental health services to support the move to parity of esteem”; Jeremy Hunt believes “nothing less than true parity of esteem must be our goal”; and in the House of Commons nearly 18 months ago David Cameron went as far as to say “In terms of whether mental health should have parity of esteem with other forms of health care, yes it should, and we have legislated to make that the case”. 

Odd then, that the president of the British Association of Counselling & Psychotherapy (BACP), Dr Michael Shooter, unveiling a major report, “Psychological therapies and parity of esteem: from commitment to reality” nine months later, should say that the gulf between mental and physical health treatment “must be urgently addressed”.  Could there be some disparity at work, between medical reality and government healthtalk?

One of the rhetorical justifications for closures is the fact that surveys show patients preferring to be treated at home, and that with proper early intervention pressure can be reduced on hospital beds. But with overall bed occupancy rates at their highest ever level and the average occupancy in acute admissions wards at 104 per cent - the RCP’s recommended rate is 85 per cent - somehow these ideas don’t seem as important as straight funding and capacity arguments.

Not to say the home-treatment, early-intervention arguments aren’t valid. Integrated community and hospital care has long been the goal, not least in mental health with its multifarious fragments. Indeed, former senior policy advisor at the Department of Health and founder of the Centre for Applied Research and Evaluation International Foundation (Careif) Dr Albert Persaud tells me as early as 2000 there were policies in place for bringing together the various crisis, home, hospital and community services, but much of that work is now unravelling.

“We were on the right path,” he says. “These are people with complex problems who need complex treatment and there were policies for what this should look like. We were creating a movement in mental health which was going to become as powerful as in cancer. We should be building on that now, not looking at what’s been cut”.

But looking at cuts is an unavoidable fact of life in 2015. After a peak of funding for Child and Adolescent Mental Health Service (CAMHS) in 2010, spending fell in real terms by £50 million in the first three years of the Coalition. And in July this year ITV News and children’s mental health charity YoungMinds revealed a total funding cut of £85 million from trusts’ and local authorities’ mental health budgets for children and teenagers since 2010 - a drop of £35 million last year alone. Is it just me, or given all this, and with 75 per cent of the trusts surveyed revealing they had frozen or cut their mental health budgets between 2013-14 and 2014-15, does Stevens’ talk of purchasing “power” sound like a bit of a sick joke?

Not least when you look at figures uncovered by Labour over the weekend, which show the trend is continuing in all areas of mental health. Responses from 130 CCGs revealed a fall in the average proportion of total budgets allocated to mental health, from 11 per cent last year to 10 per cent in 2015/16. Which might not sound a lot in austerity era Britain, but Dr Persaud says this is a major blow after five years of squeezed budgets. “A change of 1 per cent in mental health is big money,” he says. “We’re into the realms of having less staff and having whole services removed. The more you cut and the longer you cut for, the impact is that it will cost more to reinstate these services”.

Mohsin Khan, trainee psychiatrist and founding member of pressure group NHS Survival, says the disparity in funding is now of critical importance. He says: “As a psychiatrist, I've seen the pressures we face, for instance bed pressures or longer waits for children to be seen in clinic. 92 per cent of people with physical health problems receive the care they need - compared to only 36 per cent of those with mental health problems. Yet there are more people with mental health problems than with heart problems”.

The funding picture in NHS trusts is alarming enough. But it sits in yet a wider context: the drastic belt-tightening local authorities and by extension, community mental health services have endured and will continue to endure. And this certainly cannot be ignored: in its interim report this July, the Commission on acute adult psychiatric care in England cited cuts to community services and discharge delays as the number one debilitating factor in finding beds for mental health patients.

And last but not least, there’s the role of the DWP. First there’s what the Wellcome Trust describes as “humiliating and pointless” - and I’ll add, draconian - psychological conditioning on jobseekers, championed by Iain Duncan Smith, which Wellcome Trusts says far from helping people back to work in fact perpetuate “notions of psychological failure”. Not only have vulnerable people been humiliated into proving their mental health conditions in order to draw benefits, figures released earlier in the year, featured in a Radio 4 File on Four special, show that in the first quarter of 2014 out of 15,955 people sanctioned by the DWP, 9,851 had mental health problems – more than 100 a day. And the mental distress attached to the latest proposals - for a woman who has been raped to then potentially have to prove it at a Jobcentre - is almost too sinister to contemplate.

Precarious times to be mentally ill. I found a post on care feedback site Patient Opinion when I was researching this article, by the daughter of a man being moved on from a Mental Health Services for Older People (MHSOP) centre set for closure, who had no idea what was happening next. Under the ‘Initial feelings’ section she had clicked ‘angry, anxious, disappointed, isolated, let down and worried’. The usual reasons were given for the confusion. “Patients and carers tell us that they would prefer to stay at home rather than come into hospital”, the responder said at one point. After four months of this it fizzled out and the daughter, presumably, gave up. But her final post said it all.

“There is no future for my dad just a slow decline before our eyes. We are without doubt powerless – there is no closure just grief”.

Benedict Cooper is a freelance journalist who covers medical politics and the NHS. He tweets @Ben_JS_Cooper.