David Cameron: from foolhardy champion swimmer to panicked doggy-paddler

The prime minister's party conference speech had only regurgitated rhetoric, with no policy, ideas or budget to back it up.

 

Do you remember that funny 1980s film, Weekend at Bernie’s? Two losers trying to pretend that their boss hadn’t really died, so that they may continue to party at his expense? That, for me, was the inescapable image of the Conservative Party conference.

The corpse, in this case, is the government’s neoliberal economic policy, complete with comedy hat and sunglasses. The rigor mortis of contraction and unemployment is making it increasingly difficult for George Osborne to manipulate the arm into nonchalantly waving at a passing Christine Lagarde. She’s not buying it. The party is over.

I was fully prepared to write a piece attacking all the erroneous figures, the misquoted statistics, the circular arguments. But I won’t. Firstly, because it is futile; the depressing truth is that nobody with the intellect to be interested in such writing believes much of what this (or any) government says. Secondly, because, having heard Cameron’s evangelical call to arms, there are more fundamental things to address.

“I'm not here to defend privilege. I'm here to spread it”, says Cameron. The delegates cheer ecstatically. But what is the reality behind the one-liner? Privilege is by definition what one has above what others have. The very core of privilege is inequality. In short, the prime minister of a country in which less than 10 per cent of the population control more that 50 per cent of the wealth, wants more inequality. Of course he does, he is part of that 10 per cent.

Still, we mustn’t resort to the “politics of resentment”, we were told with metronomic regularity this week. We mustn’t think ill of those hard-working people who do well. The implication being that, if you’re not doing well, you’re just not working hard enough. Also, that all those who do well, have worked hard. Like Osborne and Cameron who inherited their wealth.

Cameron saluted “the doers” and “the risk-takers”. The Doers and Risk-takers in the City of London and Wall Street, those arsonists largely responsible for setting the world on fire, salute you back, David. And why shouldn’t they? They are seemingly untouchable by regulation, prosecution – and now, even resentment.

On the other hand, when it comes to resenting the poor, the unemployed, the unionised, the immigrant, the sick, the squatter, the public servant, the European, the young, the old, the intellectual, the Muslim, the demonstrator - resentment is not only allowed. It is encouraged.

In this current climate of unemployment and misery, it has never occurred to me when leaving home for a job, to be anything other than grateful that I have a job. I have never glanced at a neighbour’s drawn blinds and thought “you lucky sod, surviving on sixty quid a week”.

The reason 2.6 million unemployed cannot be shoe-horned into three hundred thousand vacancies is mathematics. Not a lack of aspiration.

That word - aspiration… Repeated again and again. “Conservatives are the party of aspiration.” They are here to help those who aspire. “The young people who dream of their first pay cheque, their first car, their first home – and are ready and willing to work hard to get those things.” More cheers from the hypnotised delegate-flock.

It doesn’t occur to David Cameron how utterly depressing it is for the leader of this country to define “aspiration” as the lust for money, cars and property.

It never occurs to him how hypocritical it is for this to come from someone who knew they would get a car as a present on their eighteenth birthday, always have a comfortable home to live in and a pay cheque guaranteed upon graduation because daddy could pull strings.

It does not occur to him how hilariously at odds this is with his rhetoric on the big society. How it exposes the idiocy of the expectation that once this fictional young person, bred to be selfish and materialistic, has accumulated enough pay cheques, enough cars, enough homes, they will go out and run a soup kitchen for those “less aspirational”.

It never even occurs to him that this mass psychosis, of judging success solely by reference to what each person can grab for themselves, is at the root of the social decay he bemoans; at the root of crime, poverty, environmental damage, the looting last summer, the financial crisis in 2008.

But most frighteningly, it does not appear to occur to him that the position of prime minister involves more than passionately delivered, hollow words.

Last year, he framed his speech with “Britannia didn’t rule the waves with her armbands on”. This year he says “it is time to sink or swim”. An elegant, if unwitting, indication of how his thinking has moved on; from foolhardy champion swimmer to panicked doggy-paddler.

The UK economy is fast becoming a small makeshift raft, cobbled together from antiquated dogma, U-turns and fiascos, adrift in a sea of global uncertainty. Selling off the planks to passing sharks is not a solution. When the water is ankle-deep, crew and passengers look to the captain for action, not regurgitated rhetoric, however deftly delivered.

All he can do is stand there and shout passionately “The Free Market will save us! Enterprise will save us! Aspiration will save us!” Abstract, deified, neoliberal concepts without a smidgeon of policy, detail or budget to back them up.

I recognised his speech for what it was: A drowning man’s gurgling prayer.

 

David Cameron. Photograph: Getty Images

Greek-born, Alex Andreou has a background in law and economics. He runs the Sturdy Beggars Theatre Company and blogs here You can find him on twitter @sturdyalex

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.