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Blogs > February 2014

February 2014

The Mental Health Concordat

18th February 2014

PCC Martyn UnderhillDear All,

Today marks a historic day. The launch of the first Mental Health Concordat. I am delighted to have been involved in the work leading up to today. Over the past few months we have seen several new initiatives and research in relation to mental health provision in England. These build on the Bradley and Adebowale reports and the HMIC report “A criminal use of police cells”

MIND and Victim Support have published a fascinating and harrowing document linking persons who are mentally ill to an increased likelihood of becoming a victim. The report also highlights that victims of crime who are mentally ill have a lesser experience from law enforcement agencies than most. It is essential reading for all law enforcement professionals and PCC’s.  

CQC published their report Monitoring the Health Act 2012/13, which highlights the continued rise of people with mental health issues along with the inconsistencies relating to out of hours cover.

The Probation Inspectorate have published their inspection report on the Treatment of Offenders with learning disabilities within the Criminal Justice System

The Government published their report called Closing the Gap, a 25 point plan to bring equity and parity between those suffering mental health as opposed to physical health issues

There is so much in the above documents I could highlight, however, I think this paragraph from the Government itself in “Closing the Gap” summarises our issues:

“People who use mental health services, and those that care for them, continue to report gaps in provision and long waits for services. There is still insufficient support within communities for people with mental health problems. In some areas there have been stories of people of all ages being transferred sometimes hundreds of miles to access a bed. We are not yet making an impact on the enormous gap in physical health outcomes for those with mental health problems. And so much more could be done to promote good mental health and prevent mental ill health”

The future

Notwithstanding all of the above, today is a watershed for people in mental health crisis. The Government, and all agencies that deal with mental health crisis publish a Concordat, an agreement on what is expected of agencies in relation to people in crisis. As the Chair of the PCC Mental Health Working Group, I have signed this document on behalf of PCCs.

The very fact that we needed a Concordat displays the crux of the problem, nationally and here in Dorset - we are not getting it right. This ground breaking document acknowledges the need for the medical profession to provide sufficient resources to cope with those in crisis in their area. This translates to three key areas that are affecting policing across England on a daily basis. The medical profession need to provide sufficient beds for those in crisis and to provide sufficient mental health professional cover, 24 hours a day, 7 days a week.

It also translates to the Ambulance service providing transport for people in crisis, 24/7. The Concordat also strengthens the desire NOT to place people in crisis inside Police Custody Suites.

In 2012/13 in Dorset, 157 persons suffering mental health crisis entered Police Custody Suites. Staggeringly, this included five children 17 years old or younger.

Every one of those 157 cases represents a failure of the system, a failure of society to provide suitable safe health based care for people who are desperately ill. And it has to stop.

So what is the role of PCCs nationally?

There are two key areas for PCCs to develop, accepting that their role brings partners and people together.

1)    A local solution

The issuing of the Concordat, and the numerous Government initiatives currently underway, needs to be translated to local solutions. Every PCC needs to reach agreement with their local health partners to reduce the demand on policing through improved primary and secondary mental health care. In other words, we need to convert the national Concordat to a local Concordat, signed up to by all relevant partners. In Dorset and across England, this is no mean feat. The amount of agencies and NHS Departments involved is staggering.  

2)    Local Governance

The provision of multi agency governance of mental health is disparate and fragmented. Some areas have fully engaged Health and Wellbeing Boards (HWB’s) with PCCs and Police sitting on them. Others (like Dorset) don’t. The problem with the HWB approach is that some areas have many HWBs for one policing area. A county wide or Force wide approach is needed.

So accepting that the governance does not necessarily have to involve HWBs, what other governance is there? Well most areas have Mental Health Boards, but membership is invariably health based and often doesn’t cover the whole policing area. That is why in some areas PCCs have set up their own Strategic Mental Health Boards, overseeing mental health provision across the Force area. Ensuring a policing voice is heard and that mental health governance becomes a multi agency approach, not just health is the second PCC challenge.

PCCs are here to not just hold Police Forces to account. When 20% of policing time is abstracted, dealing with health related issues, it is time to hold our health partners to account too

Martyn Underhill

Dorset Police and Crime Commissioner

Posted by Martyn Underhill at 11:39am

Response to Precept Debate

7th February 2014

PCC Martyn UnderhillThis week I made a big decision. A decision that Parliament, through the Police Reform and Social Responsibility Act 2011 (The Act) placed on my shoulders alone as the democratically elected and publicly accountable Police and Crime Commissioner for Dorset. That decision was to raise the police element of the council tax by 1.96%.

I made this decision (which will cost the average Band D council tax paying family an extra £3.60 per year) in order to help safeguard policing over the next four years in Dorset. This decision has been taken in the context of huge cuts to funding and increasing demands on emergency services.

The Act states that my proposals for the precept must be considered in public by a Police and Crime Panel, which happened on Thursday 6 February.

The Panel is made up of 17 members, many of which are councillors from the local authorities across Dorset. The Panel is not a decision making committee but has a role in scrutinising my proposals. The Act says that they can veto a precept proposal once, if two thirds of the panel vote for that course of action.  
At Thursday’s Panel hearing, after much debate, a 16 strong Panel voted 9 / 7 against the proposal. I stand by my decision as I am deeply involved and informed on the issues and I am of the firm belief that it is in the best interest of Dorset over the medium term. Importantly, I have been consulting for months on these proposals and 74% of respondents support them. That response was an essential element of my consideration.

Unfortunately I feel that many of the Panel members yesterday arrived having made their minds up due to external pressures and parochial political influences.

I have received three questions from the Bournemouth Echo in response to Thursday’s hearing. I would like to answer them publically:

1) What is my reaction to criticism from Dorset Police and Crime Panel?
It was quite clear at the Panel, that local politics swayed some Councillors. In particular, local pledges to not raise Council Tax dominated a ‘pan Dorset’ discussion on our policing budget. I have always said that the Police and Crime Panel should consist of members of the public directly elected to the Panel at the same time as the local elections, to hold the PCC to account. This would prevent this kind of local party political agenda swaying decision making. Those members of the public should represent the eight authority areas in Dorset and should be paid posts for 25 days per year. They would work to a mandate set by the public, to scrutinise pan Dorset policing decisions.

2) Is the process of setting a precept fair?
The role of Police and Crime Commissioners and Police and Crime Panels is set out in statute. Democratic accountability for policing is the responsibility of Police and Crime Commissioners who were elected to hold forces to account. The majority of members of the Police and Crime Panel are appointed from their own local authority. Panels provide a scrutiny role and have a power of veto, but are not directly elected by the public for this role. As set out in the Police Reform and Social Responsibility Act 2011, the Panel can veto on the first occasion, the precept proposed by the PCC, but only when two thirds of the Panel members vote for a veto. Ultimately, the decision regarding the role and powers of the Panel was agreed by Parliament and not locally. For this to change, Parliament would need to revisit the Act.

3) Was the decision made democratically?
Yes. I was democratically elected to oversee policing and crime in Dorset. A key responsibility of this post is to decide on the precept tax level that is in the best interest of residents and Dorset Police over the medium term. I am determined to hand over a debt free and efficient police force to my successor. I owe that to Dorset.

I have been left disappointed by events over the last few weeks and at the panel itself. I received intense political lobbying by Bournemouth politicians, intent on receiving my support to help them achieve their promise not to raise the council tax in Bournemouth before the next local elections. To pledge a 4 year zero rise in Council Tax during a deep recession and unprecedented cuts to public spending is naïve at best, and foolish at worst. This is particularly so when it is understood that the Police and Fire elements of the council tax are not a decision for the Council to make. I was disillusioned to find that some panel members voted according to their local political manifesto and not on the pan Dorset needs of Dorset Police.

I am proud that my democratic responsibilities are to the whole of Dorset. The reason I stood for election was to keep politics out of policing. I will make decisions based on fact, knowledge, understanding of policing and the views of the public, not on political influence or lobbying.

Martyn Underhill
Dorset Police and Crime Commissioner

Posted by Martyn Underhill at 8:09pm


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