Why are St Andrew’s passing the buck?

Yesterday it was reported that Katie Fisher, the chief executive of St Andrew’s Healthcare, a charity which runs four hospitals including a large psychiatric institution in Northampton, had “spoken out” after an internal review found that they had 36 patients who should not be in hospital but were there only because of the lack of suitable community placements or funding to allow them to go to one. She is quoted as saying:

The system is in crisis. There are people who have life-long needs who require life-long support, but those who recover or are assessed as fit to leave but then cannot are not gaining any clinical benefit from being here. It is potentially damaging, especially if they don’t know when or where they will be discharged. This is their life and not being able to move to a more suitable place or home is just wrong, unnecessarily restrictive and hugely expensive.

It’s ironic that she calls it “hugely expensive” when, of course, it is private operators such as St Andrew’s and profit-making entities such as Cygnet and Priory are making a lot of money out of this situation. It is to the public that it is expensive. St Andrew’s in Northampton is an enormous complex with numerous wards in the old building which have been abandoned as they are old-fashioned and because they have features which make supervision difficult; active wards are mostly in newer buildings. All of these operators take in patients on a regular basis they know to be unsuited to the remit of or the conditions on the ward; they know, for example, that many people admitted are autistic, yet they do not refuse to take them.

None of these organisations is impoverished; St Andrew’s, besides its considerably property portfolio, has enough to pay its chief executives six-figure salaries and big bonuses. They should not be blaming local authorities or “the system” for their practice of taking in people as patients that they know do not need their care or who are unsuited, and then keeping them in conditions which deprive them of fresh air, human contact, everyday comforts (such as an appropriately decorated room) or even essential medical treatment such as the removal of bits of a plastic pen from their arm, or keeping them locked-up or drugged unnecessarily.

Let’s have no more excuses. If St Andrew’s cannot provide appropriate care for the people they take in under the Mental Health Act or otherwise, they should not be taking money to do so. Local authorities would not be able to avoid their duties to autistic people and others with major care needs if there were not charities and businesses looking to take them in but not necessarily to care for them properly.

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