No separate Mental Health organisation for Wales.






Title:   Mental Health  

Date:   29 September 2008 

By:      Edwina Hart, Minister for Health and Social Services    



On 3rd June 2008 I initiated a discussion with interested parties on the report I had commissioned from Professor Michael Williams. His paper, ‘Iechyd Meddwl Cymru – A Well Being and Mental Health Service Fit For Wales’ envisaged the establishment of a single body for mental health that would provide a comprehensive service combining the expertise of NHS trusts and social services to deliver care throughout Wales in conjunction with primary care and the voluntary sector.


I am sincerely grateful to Michael for the care and diligency he gave to the preparation of this paper and for the excellent way in which he conducted the discussion on his ideas and raised the profile and interest in mental health in Wales. I was very encouraged that this wide debate has taken place.  368 written responses were received and 3 Regional consultation events were held, attended by almost 500 delegates.


The one consistent message that came through these discussions was that mental health services in Wales must improve and urgently.  However no overwhelming view was expressed either to support or to reject the ideas for improving services in Professor Williams’s paper. An analysis of the responses show that 41% were in favour of his proposals, with 44% against leaving 15% undecided.


Health organisations, local authorities and the learning disability sector were overwhelmingly against the proposals whilst service user groups, individual service users and some local and national charities were in favour of his ideas.


I have considered carefully all the points made and whilst there is a great deal of merit in the ideas put forward by Professor Williams, on balance I have been persuaded by the arguments against establishing a separate mental health organisation for Wales.


In coming to this decision I have specifically noted the following arguments:


  • There is good evidence of co-morbidity of mental illness and physical illness. This requires close working across mental and physical health and social services particularly for older people. A separate mental health organisation could make this more difficult
  • A single all-inclusive mental health organisation would stand the risk of becoming isolated and stigmatised. It will also depend on a complex weave of partnerships which could confuse and create boundaries to seamless working
  • There was great concern about the inclusion of learning disabilities within a single health organisation model. These services have been driven by a social model of wellbeing and any such proposed new body could medicalise these services.

 I have decided that mental health services will become a fundamental part of the new integrated local NHS bodies. However I am determined that the resources currently available for mental health services, at a minimum will be fully protected in the new organisations. I shall expect significant progress to be made to implement fully the NSF for mental health across Wales over the next 3 years.. I intend to ensure that mental health services are no longer a “Cinderella” service but have a strengthened presence within the new organisations.


Whilst much has been achieved over the last 6 years since the original National Service Framework (NSF) for mental health was published there has to be an improvement in the access to and quality of the services available throughout Wales.  No change is not an option and I will ensure that in the re-organised NHS mental health services have a very high priority.




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