Opinion: To the point - Get service priority right

Does the Government feel no conscience about cutting back services tothe neediest, most vulnerable people in this country?

A survey by the Sainsbury Centre for Mental Health showed that nearlytwo-thirds of mental health trusts have been forced to make reductionsin order to compensate for overspending elsewhere in the NHS. 'Rethink',a charity for mental illness, has found that there has already been30m slashed in this sector - a bit more than the government'sestimate of 16m.

This affects the services for children as well. For instance, inGloucestershire the Child and Adolescent Mental Health Service has beenforced to shed a tenth of staff simply to meet an imposed budget,starting from a level well below that recommended by the NationalService Framework. In spite of efficient management and committedclinicians, this will lead to fewer unhappy, confused and disturbedchildren getting the service they should have. At the same time, toomuch effort goes on thinking up ways of reducing waiting lists in orderto avoid governmental penalties. This means dreaming up hoops forchildren to jump through before they get accepted, and also spending theminimum amount of time on any one child or family. Both are dangerousattitudes that will affect many Nursery World readers and the childrenyou work with.

A lot more children are likely to benefit from specialised help foremotional or mental health difficulties than, say, for orthopaedics. TheGovernment estimates that 7 per cent of three-year-olds show moderate tosevere behaviour problems; a further 15 per cent present with milddifficulties. For older children the former figure is 10 per cent. Ifone out of every ten children could be relied upon to break a leg, canyou imagine the outcry if orthopaedics was forced to only see the oneswhere there were more than half a dozen bits of bone floating about?

- Robin Balbernie is a consultant child psychotherapist inGloucestershire.