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Crisis in Young Persons Mental Health Services in Wales

One in ten children and adolescents in Wales will experience a mental health issue, yet there are still serious concerns over the provision of Children & Adolescent Mental Health Services (CAMHS).

Waiting lists are too long, there is a lack of investment and focus on early intervention, too many young people are still inappropriately placed on adult mental health wards, safety checks are not common practice and many young people get lost in the transition between CAMHS and Adult Mental Health Services.

It’s almost a decade on since the Children’s Commissioner first warned that CAMHS provision was in ‘crisis across Wales’, yet many child health experts assert that this is still the case today. Figures compiled by the Welsh Liberal Democrats show that the number of vulnerable young people in Wales waiting more than 14 weeks to access child and adolescent psychiatric services has almost quadrupled, from 199 in January 2013 to 736 in January 2014.

In Wales we made a good start, being the first country in the UK to have a national strategy on CAMHS with the launch of ‘Everybody’s Business’ in 2001. There are examples of excellent practice across Wales, yet sadly despite action plans, frameworks and even the Mental Health (Wales) Measure, there remain significant concerns that can no longer be ignored.

This month my party hosted a debate in the National Assembly on the provision of CAMHS. In that debate we called on the Welsh Government to take a number of key steps including:

• investigating waiting times between a child or young person’s first assessment with CAMHS and their subsequent service referral;
• routinely publishing readmission statistics;
• consistent and accurate reporting of inappropriate placements on adult mental health wards;
• considering the introduction of mental health education within the school curriculum; and
• introducing a national framework to ensure continuity of treatment in the transition between CAMHS and Adult Mental Health Services.

The Welsh Labour Government voted against all of these suggestions. I am very worried they are burying their heads in the sand on CAMHS. There has been little progress since a review in 2009 and young people continue to be put at risk with a failure to address significant safety issues.

The mental health of our young people is far too important to get wrong. As with so many health issues getting the right help as early as possible makes a huge difference to the outcome for the individual. I hope the Welsh Government will act, and act quickly, to reverse the crisis in CAMHS.

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Concerns over grant for Wales’ poorest pupils after email leak

The Western Mail reports that the Welsh Government has been accused of reneging on its word and breaching budget commitments after leaked documents suggested ringfenced funding designed to support Wales’ poorest pupils will be used to meet its education spending promise:.

Pressure from the Liberal Democrats and Plaid Cymru secured an extra £35m for the Pupil Deprivation Grant (PDG), which will be distributed among schools this year and see an additional £918 allocated to pupils eligible for free school meals.

Education Minister Huw Lewis has threatened to “claw back” from schools that ignore guidance on how best to use the money and the Welsh Government has been clear that PDG funding should not be used for other purposes.

But documents seen by the Western Mail suggest the PDG is being used to meet the Welsh Government’s manifesto commitment to increase education spending by 1% above the block grant that Wales receives from the UK Government.

In an email to local authorities, Robert Hay, head of local government finance and public service performance in the Welsh Government, sought to clarify the situation with regards education funding. His note, sent on November 15 last year, said: “The settlement includes an additional £8.6m to deliver the First Minister’s commitment to provide an element of the protection to schools funding equivalent to 1% better than the change in the Welsh Government’s budget.

“This protection for schools spending has been delivered in part through an increase in the PDG. The monitoring returns for 2014-15 will be reviewed by DfES (Department for Education and Skills) to ensure they continue to provide the necessary assurance that authorities are delivering the protection.”

The Welsh Liberal Democrats’ education spokesperson, Aled Roberts has called on the minister to clarify the issue. He said: “The Welsh Liberal Democrats secured the PDG so that Wales’ poorest pupils would get a fairer start in life. It should be ringfenced for that sole purpose, used according to the published guidance and therefore be separate from the overall budget. It should not be used to provide political cover for the Welsh Labour Government in its desperate attempt to meet its 1% spending commitment.

“Evidence shows that schools are already benefiting immensely from our PDG. However, we can’t be complacent and the Welsh Government must get its act together to ensure that it is being used to effectively target those pupils that need the most help.

“Both Jane Hutt (Finance Minister) and Huw Lewis have said publicly and privately that the PDG is a standalone grant and should not be used to meet other commitments. The letter from Robert Hay is a clear breach of the budget deal and contradicts assurances from ministers.”

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Another Welsh NHS waiting list problem

Today’s Western Mail reports that evidence provided to an Assembly inquiry into orthodontic services in Wales has revealed that patients are waiting nearly three and a half years for secondary care services, often hospital treatment, while primary care waiting lists, including GP services, can stretch for up to two and a half years, with groups particularly pointing to rural areas enduring far less provision.

They say that the The government body tasked with tackling public health issues has also questioned whether the current spending on orthodontic services is sustainable amid continuing austerity:

Public Health Wales said it must be “closely questioned” whether services should be offered, on the NHS, outside of the most serious cases, given that Welsh children have the worst oral tooth health in the UK.

But the responses raise the spectre that NHS-funded orthodontic care could be dramatically scaled back unless funding is hiked dramatically.

The extent of the problem has emerged through evidence to the National Assembly’s Health and Social Care Committee inquiry, which is investigating how orthodontics – which corrects crooked or abnormally arranged teeth – is provided for in Wales.

Debra Worthington, chair of the Orthodontic National Group, said secondary care waiting times in Wales were up to 40 months, while waiting times for primary care services could reach up to two and a half years.

“The lengthy waiting times for orthodontic treatment, both in primary and secondary care, has resulted partially from a chronic underfunding of orthodontic care,” she said.

She added: “We recommend that the Welsh Government funds a one- off waiting list initiative to clear the backlog of patients waiting for orthodontic treatment.”

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Welsh public support ban on smoking in cars

The Western Mail reports that research has found that 81% would be in favour of legislation to ban people from lighting up in cars carrying under 18s while just 13% were opposed to it.

Support for a ban in cars carrying adult passengers was slightly lower at 59%, while just 39% said they supported a ban in all private vehicles:

The poll also found that opinion was split on whether to ban e-cigarettes in public places, with 40% in favour and 45% against.

It follows the a public health bill white paper which included a proposal for Wales to become the first in the UK to ban e-cigarettes in enclosed public places.

The Welsh Government has argued that the rise in popularity of the products could undermine the smoking ban and they could be a “gateway” into smoking regular cigarettes, but those against the move have said many smokers use e-cigarettes as an aid to quit.

Health experts who have campaigned for the introduction of legislation to ban smoking in cars carrying children strongly welcomed the results of today’s poll.

Dr Richard Lewis, Welsh Secretary of the British Medical Association (BMA), said:“BMA Cymru Wales welcomes the results of this survey which show that the public in Wales is behind a ban on smoking in cars carrying children.

“This is an important step forward in the campaign to reduce tobacco harm by stopping children from being exposed to second-hand smoke in private vehicles because it demonstrates the strong support for such legislation.

“Children are still developing physically and, as a result, they are more susceptible to the harmful effects of second-hand smoke.

“Adults who smoke in the presence of children are not acting in the children’s best interest; therefore it is the Government’s duty to change legislation in order to protect them.”

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Paying for high child care costs

If you are a parent you will know about the high costs of child care. In Wales we have some of the highest child care costs in the world. That is why the Liberal Democrats in the Welsh Assembly have been raising this issue during recent debates.

The Family and Childcare Trust’s annual childcare survey for 2014 showed that childcare costs in England are falling for the first time in twelve years, whilst in Wales the cost of nursery care for under twos has significantly increased.

Only five local councils in Wales report that they have sufficient places for places for under twos. And in rural areas not one council is offering adequate provision.

The Welsh Government points to its Flying Start scheme to help families on low incomes but this is confined to urban areas and for large parts of Denbighshire it is irrelevant. More needs to be done to help families with nursery provision for under 2s in Wales.

In England , from September 2013, 20 per cent of or 2 year olds from the most deprived backgrounds have been entitled to 15 hours of free childcare and this will rise to 40 per cent this year.

Good and affordable nursery provision benefits the economy. It makes it easier for families to work or improve their employability by training and studying.

And there was some good news which many papers and commentators missed in the mass of information that was produced for the Budget last month.

Working families throughout England and Wales will be given up £2,000 to ease the cost of childcare as part of a scheme which will start next year. A family with two children under 12 years old could gain in one year up to £4,000. People on the new Universal Credit will also benefit. They will get 85 per cent of their childcare costs fully covered.

These new policies will be of enormous help because average child care costs can amount to around £800 or £900 a month which currently mean it is hardly worth returning to work. For over 18,000 families in North Wales this will mean that from next year they will be able to go out to work without worrying about being penalised by childcare costs. That is what I call radical change.

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Vince Cable cracks down on ‘dodgy directors’

The Western Mail reports that the Government will reveal today its latest plans to bring forward proposals aimed at delivering more restrictions and punishments on so-called “dodgy directors”:

Directors convicted of a commercial offence overseas would be banned from running British companies under the plans, Business Secretary Vince Cable said.

The Department for Business, Innovation and Skills (Bis) said courts could also be asked by the Government to award compensation against a disqualified director, although the court would have the final say.

Judges may have a “duty” to take into account more factors – such as previous business failures and overseas conduct – when assessing if someone should be disqualified, the department added.

It is understood the measures are expected to be brought forward as part of the Government’s legislative programme for the next session of Parliament, which will be outlined in the Queen’s Speech on June 4.

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