It is inarguable
that the number of people with a mental health diagnosis has increased. It
doesn’t follow from that, however, that Wes Streeting is right to claim that there is
‘over-diagnosis’. There are a number of reasons for the increase in the number
of people with a diagnosis, including a reduction in stigma for those seeking
help as well as a better medical understanding of some conditions. It doesn’t
matter whether a health problem is down to physical issues or mental issues (and there's an argument that many mental health issues have underlying physical causes anyway): as
a general rule, identifying more sufferers and providing them with the right treatment
and support is surely a good thing rather than a bad one. That some people will
be misdiagnosed or wrongly diagnosed is inevitable. It happens with all sorts
of illnesses, always has and always will. When cases are numbered in the
millions, achieving 100% accuracy is an impossible target.
That doesn’t seem to
be the understanding of the English Health Secretary, though. He seems to have
in mind that there is a ‘right’ number of diagnoses, and that that number is
lower than the actual number currently being recorded. His basis for making
that assumption is unclear. Maybe he can explain it clearly and succinctly, but
he hasn’t done so thus far. It’s hard to avoid the conclusion that his main
driver for making the assertion has more to do with the costs than health –
both the direct costs of treatment and the indirect costs of lost productivity
from people who aren’t working. It isn’t just him: there seems to be an
underlying attitude amongst Sir Starmer and his ministers that many of those
who are not working due to poor health are lazy lead-swingers who need to be
forced into work regardless of the consequences for their health. I doubt that
anyone would argue that there are no people at all in that latter category, but
there is no evidence of which I’m aware that the problem is anything like as
widespread as the government seem to be assuming. By concentrating his attention
on mental health issues, Streeting is in danger of reviving the stigma which
has taken decades of work to reduce.
He is, of course, only
responsible for the English NHS, and his approach doesn’t necessarily have to
be replicated here in Wales, although if Labour MPs are dragooned into going
along with him, neither is it certain that the approach will not be more widely
applied. But any cuts to benefits or to mental health services implemented on
the back of dodgy assumptions certainly will affect people here. His wish to
eliminate duplication
and waste in the NHS is understandable, but saving money by having sweeping
diagnoses made by bean counters and politicians rather than by doctors is
surely a step too far.
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