Anti-TTIP protesters take to the streets. Photo: Getty Images
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People's concerns over TTIP must be heard

Public anxiety over the Trans-Atlantic Trade Partnership (TTIP) must be listened to, and addressed. 

An important vote was passed in the trade committee (INTA) of the European Parliament today, which will impact upon the future of a trade deal currently under negotiation between the European Union and the United States. If passed, the Transatlantic Trade and Investment Partnership, or TTIP, will be the biggest agreement of its kind, shaping the rules governing a quarter of all global trade. It is also the issue about which I have received an unprecedented number of emails from constituents and campaign groups. Emails expressing concern that TTIP will lead to reduced transparency and accountability, pressures on wages and social dumping, a weakening of health and safety standards and a hampering of our efforts to tackle climate change.

I want to ensure that we get the best deal for European citizens. A positive outcome on TTIP could present a unique opportunity to regulate globalisation and to promote the high standards on which the European Union (EU) prides itself. This can only be achieved if the people it will affect are given the chance to have their say.

As Member of the European Parliament (MEP), member of the European trade committee and the European Labour Party's spokesperson on TTIP, it is my duty to ensure that these voices are heard in Brussels and Strasbourg, and since being elected in May last year I have made this a priority. I have met with hundreds of campaigners, attended dozens of events and written at length on the state of play in the Parliament. I have listened to the public's concerns and tried to explain in the clearest terms possible the complicated process of negotiations, so that UK citizens know what is and isn't at stake.

It is important to note that it's the European Commission, not the European Parliament, which leads negotiations on trade deals in the EU. In fact, MEPs have no role in the negotiating process at all. What we do have is the power to veto any trade deal that does not satisfy our demands or the demands of our constituents. This is a blunt tool - MEPs can only say yes or no - however the threat of a negative vote means that we can have an influence on negotiations, however indirect. Knowing that MEPs will have the final say, it would be very unwise for the Commission not to take into account the Parliament's position on TTIP.

As such, the Socialists and Democrats in the European Parliament, together with other progressive political groups, have wasted no time in making clear what we are willing to accept in a final trade deal, and what we would reject. We have consistently pushed for the current European Parliament to formally adopt a position on TTIP, to set out in advance our conditions for supporting any deal with the US.

But in order to get this resolution, we need the numbers. Since we don't command a majority on our own, or even together with the greens and the radical left, this means agreeing common demands with the conservatives and / or liberals.

In this context, this week was a brilliant first step forward. A resolution adopted in the trade committee set out our position on a wide array of issues. It is, however, just a first step: the texts adopted in committee (by 41 MEPs) will then be voted by the plenary of the European Parliament, which will confirm the position on TTIP of all 751 MEPs. This crucial second vote will take place on 10th June 2015.

One such position contained in this resolution calls for an assurance that all public services - including the NHS, water, social services, social security and education - are exempt from the scope of an EU-US trade deal. Importantly, we have also demanded that national and local authorities retain the full right re-nationalise any public services currently under private control. In the context of the rapid privatisation of the NHS currently being overseen by the Conservatives, the inclusion of this clause will be highly significant for any future UK government wishing to reverse such a trend.

Anyone that has heard David Cameron call our concerns for the NHS "nonsense" last November will appreciate the significance of this victory.

This resolution is largely based on recommendations we've received from public services users, providers and employees. It was already the position of the Labour Party and European Socialists. It is now the position of the trade committee, and hopefully it will become the position of the whole European Parliament on 10 June.

We have also managed to secure strong provisions to defend binding labour safeguards in a future agreement, so as to prevent social dumping. The outcome on standards is significant, too. The text we agreed on the infamous "regulatory cooperation", which some multinationals and Tory MEPs view as a way to bypass Parliament in order to slash our standards, is a clear rejection of undemocratic power-grabbing of any kind. 

Finally, the outcome reached in the trade committee on private tribunals - known as Investor State Dispute Settlement or ISDS - is an important victory, even if it is not ideal. I had tabled an unambiguous amendment against ISDS, for which I had gathered the support of 66 Socialist MEPs.

My position on ISDS is clear. While we may include investment protection rules in trade deals, I do not believe that these rules should be enforced through special private tribunals in which multinationals can secretly sue governments for implementing policies that threaten their current and future profit margins. I have defended the use of national courts in TTIP, and I'm sympathetic to the idea of creating an international tribunal in the medium- or long-run so that all countries have access to the same system. However any outcome that threatens elected policymakers from implementing laws as they see fit is nothing short of unacceptable, and I will vote against any such measure.

The position adopted this week is a compromise on my amendment, though it nonetheless favours the use of public courts instead of any investor-state dispute settlement mechanism. To me this means no ISDS in TTIP.

This is not the end of our fight. On 10 June, the text we adopted this week in committee will be put to the vote in a plenary session of the European Parliament. This will give us the opportunity to table amendments again, and I will continue to press for a strong position from the Parliament that includes an explicit rejection of ISDS. Labour MEPs will of course support such a move, but in order to win this vote we will need the support of Tory, UKIP and Lib-Dem Members, too. This week's vote is proof that when the people make enough noise, MEPs with the power to influence positive change listen. Another big push to convince those politicians not already on side - via social media, via letters and emails and via collective public action - could make all the difference. As we approach this important next hurdle, I urge you to all to make your voices heard loud and clear.

 

Jude Kirton-Darling is Labour MEP for the North East of England

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.