Health campaigners have warned NHS bosses of dire consequences across North Yorkshire, York and the Tees Valley if approved proposals to close another mental unit are completed.
Tensions boiled over as North Yorkshire County Council’s scrutiny of health committee heard Tees, Esk and Wear Valley NHS Trust had asked its board to close a Harrogate mental health unit and scrap long-held plans to build a £16m mental health hospital in the town at the same time a mental health unit was being closed in Northallerton.
The trust’s director of operations, Adele Coulthard, said it aimed to increase the level and intensity of community services in order to reduce the need for people to be either admitted to or have extended stays in hospital.
After stating the trust aimed to provide in-patient beds where hospital admission is required from larger, more specialist facilities, such as at York, she voiced frustration about being repeatedly challenged by councillors who appeared incensed by the trust’s recommendations.
The committee’s chairman, Councillor Jim Clark, said it was very unfortunate the Harrogate inpatient facilities could be lost while the county was also in the process of losing the facility serving the neighbouring districts of Hambleton and Richmondshire.
He said: “The country is crying out for mental health beds and yet in Harrogate they are going to be closing them, in Northallerton they are going to be closing them.”
Questioning the rationale behind abandoning plans for a new mental health hospital in Harrogate, he said: “I can’t believe things have changed so much in the last few years that you are now going to be writing off millions of pounds of taxpayers’ money in relation to this.
“Why can you not use the beds you have planning permission for on land that you own that contracts are more or less ready to be signed and yet you are going to be building more beds in York?”
Ms Coulthard replied: “Language is interesting and your position is interesting. We are not closing anything, we are re-providing services, re-providing beds.”
Cllr Clark countered: “You are closing the Briary Wing.”
Ms Coulthard answered: “We are closing the Briary Wing. We are not closing the beds, the beds will be transferred.”
Cllr Clark said: “You are moving the beds to York, rather than have them in Harrogate.”
Ms Coulthard said the planned unit at Harrogate had been mixed sex and rules surrounding mixed sex units had changed over the last four years.
She added the proposed changes would mean a clinically safe service that was also “cost-effective within the patch”.
The meeting was told the underlying principle of the proposed changes was to “improve outcomes and treatment for our population”.
She said the case for change was underlined by there already being a lack of capacity in Harrogate and very limited range of community services.
However, Nigel Ayre, operations manager of Healthwatch North Yorkshire, told the meeting it was uncertain whether alternative units would be able to support extra patients generated by the closure of the Briary Ward at Harrogate Hospital, which stood at a 94 per cent level of occupancy.
He said while mental health units had a target of 85 per cent occupancy, figures for 2018 showed occupancy rates of 92 per cent in Durham and Darlington, of 103 per cent in Teesside, 95 per cent in North Yorkshire before the loss of beds at Northallerton and 90 per cent in York and Selby.
Mr Ayre added: “The facility at York is a significant risk given that it does not have planning permission for any additional beds for Harrogate residents. There are also significant risks given the necessary work being undertaken at Roseberry Park (Middlesbrough) and the ongoing closure of the mental health unit in Northallerton. ”
He said while the trust’s surveys had shown people wanted better community mental health services, “the engagement material that we have seen did not clarify to the public that closure was a significant possibility nor that their comments would potentially be used to justify that position”.
Mr Ayre said: “The alternative proposals, sending patients to York or Darlington, entails adding significant travel distance for individuals and families who are already struggling. It would be even more difficult for those reliant on public transport.”
He added visitation and social support was far more important to the treatment of mental health problems than for physical care and potential for low voluntary admission rates would heighten the potential for individuals to reach crisis point.
Mr Ayre said a great deal of positive work had seen North Yorkshire move from the only region in England with no health-based places of safety for people at crisis point to one with four, but the proposals could lead to only two in England’s largest county. In addition, he said, the Harrogate facility had been used as a justification for the closure of the Northallerton site.
He urged the trust to reconsider its recommendation and launch a thorough consultation exercise with the public.
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