On 11th June 2019 Brooke Martin, who was 19, was found
suspended from a ligature point in her bedroom at Chadwick Lodge Hospital run
by Elysium Healthcare. She had diagnoses of Autism and Emotionally Unstable
Personality Disorder and had been detained under s.3 of the Mental Health Act.
The inquest ended on 1st July 2021.
The solicitor for her family stated that the inquest had
revealed “stark failures in risk assessment, information sharing and
observation setting in a mental health hospital dealing with an exceptionally
vulnerable patient group.”
The inquest heard that only 5 days before her death she
had tried to hang herself, but this incident was not properly recorded or
communicated with staff and there was no risk assessment or review of her
observations. Earlier that evening Brooke was twice found by staff to have
something that could be used as a ligature which she had concealed under her
duvet. No action was taken as a result of this that could have protected her.
Elysium Healthcare admitted that had they taken
appropriate action, Brooke would not have died.
Elysium Healthcare was founded in 2016 and is owned by BC
Capital. They bought up several mental health hospitals, mainly from the Priory Group and
Partnerships in Care.
For the year ended 2019 Elysium reported a turnover of
over £74 million. This came predominantly from either NHS England or Clinical
Commissioning Groups – in other words, public money that would otherwise have
been spent on services within the NHS.
A couple of weeks ago I reported on the death of Peggy
Copeman, who died in a private ambulance on the hard shoulder of a motorway,
while being transferred from the Cygnet Hospital in Taunton, another private
hospital. She was allowed to leave the hospital despite her being “the most
poorly patient on the ward”.
Another major provider of private mental health beds is
In 2017 the Priory Roehampton was rated “inadequate” by
the CQC, and there had been little improvement when it was inspected a few
Priory Healthcare also owns St John’s House in Suffolk.
This is a specialist unit providing a low and medium secure environment for men
and women with learning disabilities. They are all detained under the Mental
In December 2020 it was placed in special measures, after
a CQC inspection saw CCTV footage showing "a patient being dragged across
the floor... a patient being pushed over and the seclusion room door trapping a
patient's arm and making contact with a patient's head when closed". On five
occasions staff were asleep when they should have been completing patient
observations. There was low staffing, with a heavy dependency on agency
workers, poor record-keeping and 204 instances of physical restraint in a
A subsequent inspection in April 2021 discovered that
many issues causing concern “remained unchanged”. They again found staff were asleep when they
should have been observing patients, including all three members of staff
assigned to one patient. The CQC said "Our latest inspection found the
overall quality of care had not improved and many of the issues we previously
raised remained unchanged."
You might think that private psychiatric hospitals would
offer levels of care superior to NHS hospitals, since isn’t that what you would
expect if you were paying for care and treatment? But frequently the reverse is
A Guardian report from 5th July 2021 revealed that there
were 23,447 NHS mental health beds in 2010-11 but only 17,610 in 2020-21, a
reduction of 5,837 (25%). This is in spite of the fact that there has been a
21% increase in people involved with mental health services since 2016, and an increase of 53% of people being
detained under the Mental Health Act, 13,437 in March 2016 to 20,494 in March
this year. This has inevitably led to a huge increase in people being admitted
to out of area beds – this being a euphemism for “private hospitals”. These
beds are frequently over 100 miles away.
In March 2021 alone the NHS spent £11.5 million on
funding out of area placements.
These private placements can be enormously expensive. As
Keir Harding, who has long been a champion of improving servicers for people
with personality disorder, has pointed out, a locked rehabilitation unit
claiming to be a specialist personality disorder unit will charge around
£250,000 a year per patient.
For over 10 years, the Conservative Government has
tampered with the NHS and services for people with mental health needs,
weakening or destroying effective community based services, cutting funding to
local authorities, who are responsible for social care, and forcing the
increased use of private hospitals.
You can reduce the numbers of psychiatric hospital beds,
or you can cut back on community services, but if you do both, it won’t save
money, it will simply put pressure on other public services, such as A&E
departments, the courts, and the police and ambulance services. Most
importantly it creates misery for people who are denied the care and treatment
they need, forcing them into avoidable and traumatising situations.
One example of this is the now discredited Serenity
Integrated Mentoring (SIM) scheme, which many areas have been introducing
(without any significant evidence of efficacy) as a means of managing people
with emotionally unstable personality disorder who appear to be
disproportionately coming to the attention of A&E, police and ambulance
services. Rather than offering a therapeutic approach to dealing with their distress,
the outcome is often to criminalise people and if anything to increase their
Private, for profit, hospitals should have no place in
the effective provision of mental health services. The only solution is
reinstating proper funding for health and social care. The new Health and
Social Care Secretary, Sajid Javid, has an opportunity to rectify this. As MarkTrewin recently said in Community Care:
"We have a new Secretary of State who has the opportunity to put right some of the mistakes of the past. Let’s have a social care reform plan before the end of this year that is creative and radical, that includes mental health, younger people and autism and that is designed with people who use services to genuinely improve the lives of all those people with mental health issues currently struggling within the system, and the hard-working professionals who work with them."