Ed Miliband attends the launch of an online mental health resource. Photo: Getty
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It is no longer enough for our parties just to talk about mental health

Since the last election, mental health has risen higher in the agenda than many campaigners even dreamt of. Labour, however, is behaving as though just talking about the issue is still good enough. 

Of all the many depressing developments in politics over the past years there has been the odd beam of light breaking through the cloud; one such beam is mental health. Mental health has become steadily more and more important in Westminster politics and now it figures as a significant element in each party’s health policy. Every party will at the very least mention mental health in the short paragraphs that they will try and win the public’s votes with. But lip service is no longer enough and sadly Labour in particular is guilty of doing just that.

It’s not all that often that the Lib Dems are called the most progressive of the three main parties and although it would be contentious to call them the most progressive party on mental health, it is not controversial to say that they are the clearest on it. Nick Clegg’s conference speech last year was filled with mental health announcements, including the much lauded announcement creating waiting times for the first time for mental health. Despite the fact that the financial figures used in his speech were a mish-mash of government plans and manifesto promises, the Lib Dem website explicitly lists the party’s financial commitment for mental health. £400m is to go on psychological therapies and £54m on widening children’s access to mental health care.

The Conservative party has publically declared mental health to be a priority, Jeremy Hunt’s conference speech last year proved as much. But when it comes to specific policy commitments there are none of any substance. This makes a degree of sense since mental health seems to have largely been delegated to their coalition partners. However, this excuse is not one that Labour can use; Andy Burnham has won a fair amount of praise for his adoption of "whole-person care", an integrated system of health and social care, giving due priority to mental health. Beyond this though, there has been little progress toward any kind of precise figures and/or policy.

Whereas the Lib Dems have pledge £54m to the problem, Ed Miliband has so far only really identified that children’s mental health is a problem. Children’s mental health services have suffered a real terms cut of 6 per cent since 2010, a "neglect" that Miliband has rightly pledged to stop. Aside from showing us how much they have been cut and saying that Labour will increase spending, we are voting blind on this; how much will they increase spending by? When?  Where will they target the money?

Labour’s recently released independent report on mental health by Stephen O’Brien, which has been two years in the making, has committed the same crime as the central party; it comprehensively identified the problems and false economies in our current approach, but it hasn’t provided any solutions. This is a problem across all parties; considering that the field is pretty well open for any of the main 5 parties to play a role in the next government, there is a worrying lack of specifics and figures. The election is 92 days away, that is fair enough, but soon enough they will need to tell us what they intend to do.

There is an opportunity right now, before the manifestos are launched, for the political parties to take mental health seriously enough to get specific and set out their spending plans. Mental health funding is in dire straits and it is absolutely not adequate just to say you think it’s important. If Labour is not careful, this playing-it-safely approach will give the other parties an open goal on mental health, in much the same way that they let the Tories score on postgraduate funding. As the main opposition party, they cannot let that happen. 

Dan Holden is deputy editor of Shifting Grounds

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Junior doctors’ strikes: the greatest union failure in a generation

The first wave of junior doctor contract impositions began this week. Here’s how the BMA union failed junior doctors.

In Robert Tressell’s novel, The Ragged-Trousered Philanthropists, the author ridicules the notion of work as a virtuous end per se:

“And when you are all dragging out a miserable existence, gasping for breath or dying for want of air, if one of your number suggests smashing a hole in the side of one of the gasometers, you will all fall upon him in the name of law and order.”

Tressell’s characters are subdued and eroded by the daily disgraces of working life; casualised labour, poor working conditions, debt and poverty.

Although the Junior Doctors’ dispute is a far cry from the Edwardian working-poor, the eruption of fervour from Junior Doctors during the dispute channelled similar overtones of dire working standards, systemic abuse, and a spiralling accrual of discontent at the notion of “noble” work as a reward in itself. 

While the days of union activity precipitating governmental collapse are long over, the BMA (British Medical Association) mandate for industrial action occurred in a favourable context that the trade union movement has not witnessed in decades. 

Not only did members vote overwhelmingly for industrial action with the confidence of a wider public, but as a representative of an ostensibly middle-class profession with an irreplaceable skillset, the BMA had the necessary cultural capital to make its case regularly in media print and TV – a privilege routinely denied to almost all other striking workers.

Even the Labour party, which displays parliamentary reluctance in supporting outright strike action, had key members of the leadership join protests in a spectacle inconceivable just a few years earlier under the leadership of “Red Ed”.

Despite these advantageous circumstances, the first wave of contract impositions began this week. The great failures of the BMA are entirely self-inflicted: its deference to conservative narratives, an overestimation of its own method, and woeful ignorance of the difference between a trade dispute and moralising conundrums.

These right-wing discourses have assumed various metamorphoses, but at their core rest charges of immorality and betrayal – to themselves, to the profession, and ultimately to the country. These narratives have been successfully deployed since as far back as the First World War to delegitimise strikes as immoral and “un-British” – something that has remarkably haunted mainstream left-wing and union politics for over 100 years.

Unfortunately, the BMA has inherited this doubt and suspicion. Tellingly, a direct missive from the state machinery that the BMA was “trying to topple the government” helped reinforce the same historic fears of betrayal and unpatriotic behaviour that somehow crossed a sentient threshold.

Often this led to abstract and cynical theorising such as whether doctors would return to work in the face of fantastical terrorist attacks, distracting the BMA from the trade dispute at hand.

In time, with much complicity from the BMA, direct action is slowly substituted for direct inaction with no real purpose and focus ever-shifting from the contract. The health service is superficially lamented as under-resourced and underfunded, yes, but certainly no serious plan or comment on how political factors and ideologies have contributed to its present condition.

There is little to be said by the BMA for how responsibility for welfare provision lay with government rather than individual doctors; virtually nothing on the role of austerity policies; and total silence on how neoliberal policies act as a system of corporate welfare, eliciting government action when in the direct interests of corporatism.

In place of safeguards demanded by the grassroots, there are instead vague quick-fixes. Indeed, there can be no protections for whistleblowers without recourse to definable and tested legal safeguards. There are limited incentives for compliance by employers because of atomised union representation and there can be no exposure of a failing system when workers are treated as passive objects requiring ever-greater regulation.

In many ways, the BMA exists as the archetypal “union for a union’s sake”, whose material and functional interest is largely self-intuitive. The preservation of the union as an entity is an end in itself.

Addressing conflict in a manner consistent with corporate and business frameworks, there remains at all times overarching emphasis on stability (“the BMA is the only union for doctors”), controlled compromise (“this is the best deal we can get”) and appeasement to “greater” interests (“think of the patients”). These are reiterated even when diametrically opposed to its own members or irrelevant to the trade dispute.

With great chutzpah, the BMA often moves from one impasse to the next, framing defeats as somehow in the interests of the membership. Channels of communication between hierarchy and members remain opaque, allowing decisions such as revocation of the democratic mandate for industrial action to be made with frightening informality.

Pointedly, although the BMA often appears to be doing nothing, the hierarchy is in fact continually defining the scope of choice available to members – silence equals facilitation and de facto acceptance of imposition. You don’t get a sense of cumulative unionism ready to inspire its members towards a swift and decisive victory.

The BMA has woefully wasted the potential for direct action. It has encouraged a passive and pessimistic malaise among its remaining membership and presided over the most spectacular failure of union representation in a generation.

Ahmed Wakas Khan is a junior doctor, freelance journalist and editorials lead at The Platform. He tweets @SireAhmed.