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Psychiatrists heading for relegation in ‘disease prestige’ league table

Posted on 11 June 2009 | 10:06am

I promised an update on my morning with the psychiatrists in Sedgefield, and I
really really tried to get it to you yesterday. Don’t blame me. Blame something
called Globetrotter Connect on my laptop. Whichever bits of the globe it was
connected to, they didn’t include any of the bits where I was trotting and from
where I was trying to send something. 

It is a horrible feeling, isn’t it, as you toil (moderately) over a blog, press
the button to send it to the website, and up pops that ‘cannot display the
page’ thing. What I want to know is – where do the words go? They vanished all
over the North East of England.

I tried in a hotel, then a car, then Darlington train station, then
the train itself, each time starting all over again. Then I gave up and said
sod it, I’ll wait till I get to my desktop.

Anyway, it went fine thank you. It was in the hotel in Sedgefield where I used
to go for a nap on election days while TB was careering round the constituency.

I did my usual stuff on stigma and discrimination, a good q and a, a book
signing then headed back to London for my night out with the Calendar Girls to
raise money for Leukaemia Research at the Noel Coward theatre last night. Vlog
and clips from my on stage q and a with the original Calendar Girls to follow.
Great show. Fantastic cast. Audience moving effortlessly from gales of laughter
to rivers of tears. Don’t miss it. Buy the new calendar as well. Oh, and I
secured a pledge from the oldest Calendar Girl, Beryl Bamforth, that they’ll do
another one in ten years, when she’ll be 85. ‘I’ll use my zimmerframe to hide
things,’ she said. 

On the NHS psychiatry event, the most interesting thing
for me was the little speech by the guy introducing me, NHS psychiatrist and
education director Lenny Cornwall.

He spoke about a piece of research in Norway, analysing the views of doctors
and medical students about what diseases, operations and branches of medicine
they most valued and respected.
This led to something called a ‘disease
prestige’ league table!

Top of the league was myocardial infarction (don’t ask me), followed by
leukaemia (excellent) with spleen rupture in the bronze medal position, brain
tumour fourth and testicle cancer fifth.

They only had 38 conditions and diseases to choose from and mental health came
way down the list. Schizophrenia was 34th (trailing inguinal hernia, sciatica
and femoral neck fracture). Depression was 35th, anxiety 37th, with only
fibromyalgia (don’t ask me 2) lower in the relegation zone.

I was pleased to see that my other illnesses, ulcerative colitis and asthma,
were holding their own mid-table but it was depressing (in a not literal sense
of the word) to see mental illnesses so far down.

A separate survey on
branches of medicine had brain surgery as the Barcelona of the disease prestige
table, followed by Man U as thoracic surgery, cardiology, anesthesia and
paediatrics. Psychiatry was fourth bottom, with physical medicine,
dermatovenerology and geriatrics all that separated it from the Norwegian
equivalent of the Blue Square Premier.

I know we are not Norway, but the psychiatrists in the room felt it would be
much the same here. Back to the point I made on the blog yesterday about them
sometimes seeing themselves as the Cinderella service.

And this all matters when it comes to fighting and winning battles for
resources in Whitehall, as I will remind the new Health Secretary Andy Burnham
today. He is making his debut big speech as health secretary at the NHS
Confederation conference in Liverpool, and I am due to speak on mental health
stigma and discrimination after him. It seems a good time to remind him that if
one in four of us will directly suffer some kind of mental illness at some
point, that has to be reflected in resources, and the direction of travel set
by his predecessors has to be kept up.

  • Charles Wallace

    This is a really serious point … as the battle for resources intensifies, the ones at the bottom will get squeezed. it is why you have to keep arguing for improved mental health services. More people are mentally ill than have cancer yet … we know where the money goes

  • Peter

    I am at the conference you are speaking at today. Please point out that the NHS itself, as a big employer, has to set an example. The bad truth is that within the health services there is the same stigma and discrimination you talk about. It should be the first place where we see it broken down

  • Terry Evans

    The new health secretary AB has a difficult job now distributing diminishing funds if the Dep. for Fiscal studies are to be believed and will obviously have to prioritize. It is a shame that within the medical profession psychiatry comes so low down the list considering it will affect such a large amount of us either directly or indirectly. The introduction of care in the community by the last government was an abdication of responsibility and this government should have reversed most of that policy. I have huge respect for you for dedicating yourself to this cause. Keep up the good work.

  • Jane A

    I think it is regrettable that psychiatry ranks so low. One of the reasons I wanted to work in mental health was that there seems to me real complexity in fixing a problem a doctor can’t see or touch, as opposed to resetting a broken leg or making a diagnosis of something visible and perceivable.

    Working with the inside of someone’s head always strikes me as somehow magical. That isn’t to deride all the very skilled doctors who work in physical health, but to work with the “invisible” conditions as a calling always has impressed me.

  • christine higginbottom

    Dear Alistair, I have no doubt whatsoever that if Andy Burnham visited mental health day centres around the country, and actually saw the people there, he would never ever deny them all the help possible. It is a shame to us all that the mentally ill are treated very badly indeed.

    Thank you, Christine

  • Gary Emerson

    As CEO of Darlington Mind (the nearest Mind group to Sedgefield) I was disappointed to have missed your speech but it certainly seems as though you hammered home the message amongst the medical profession. I’ve just written to Alan Milburn asking him to ask you whether you might consider coming up to Darlington (again….sorry) to speak at our own regional mental health and stigma conference later this year. Alan is also going to invite Andy Burnham too and we’re hoping Ruby Wax might agree to Chair the event.

    I do hope you can agree to come and share some of your real experiences with people with mental health issues as well as some of the medical profession as it would be a real boost for us as Darlington Mind celebrates its 30th anniversary year. Best wishes and keep up the good work. Gary Emerson

  • Christine Higginbottom

    Dear Alistair, As a mum with a son who has a severe, enduring mental illness, and in a town (Blackpool) that is to implement changes to mental health day services, who will speak up for our mentally ill?

    It would be fantastic if it were possible for me to reel off a list of names, Ruby Wax, Andy Burnham, Stephen Fry, yourself, all lined up to help any way they can.

    However that is not the case, here in Blackpool we need help to preserve our day centres.

    Thank you, Christine.

  • Alina Palimaru

    Thanks for all the work on this issue. You are amazing. Tip regarding blogs: try typing them in a Word document first, save them, and then copy and paste to your blog. It’s very easy and this way you only write once and send whenever your connection enables you to. If the connection fails, your text is not lost.

  • Paul Hodges

    Thanks for this, as ever AC. Myocardial infarction is a good old classic heart attack by the way. Interestingly enough in medical workforce planning circles the increasing feminisation of the medical workforce is worrying some (not me particularly). The somewhat misguided argument being that female doctors don’t like the classically prestigious surgical & oncological specialities as they involve too much hard training and on call hours – ‘softer’ specialities such as psychiatry and general practice should by this theory benefit. The funny thing is that many specialities (apart from the surgeons) regard themselves or their disease as the real ‘Cinderella’ cause. Certainly the case with obstetrics & gynaecology of which I have the most knowledge. All adds to the ever growing NHS pressure. One thing we all know is that the (now denied, but likely) 10% cuts of the Tories are not the solution.

    When’s your blog on Ronaldo going up? 🙂

  • Katharine T.

    It’s the same problem here in Canada for both mental health and addiction. Even if I could afford a shrink (can’t, and it’s not covered here) I wouldn’t be able to find one that didn’t have a two year waiting list. Same with addiction; I finally got up enough nerve to call the government sponsered program. After a month of ringing and leaving messages I was told that a)I’m not considered critical enough to be a priority (first I’ve heard that a lack of seizures or hallicinations with a bottle of wine a day was a bad thing, but hey, I’m not the doctor) b) There was a 10 week waiting list.

    That was about 12 weeks ago and I’m still waiting. Not that I’m complaining mind you…whinging accomplishes nothing. I do find it morbidly humourous though. However, I feel very bad for those who are desperate and seriously ill.

  • goldfish

    Is mental health the Cinderella of healthcare services? I used to work for a mental health charity. There’s only what statistic I really remember. Who is the person most likely to kill your young daughter? Her dad? Her boyfriend? A stranger? No, your daughter herself. Cinderella would cry!

  • Bar Bar of Oz

    Speaking of mental health, I see Martin Bright has broken out in a severe attack of Alistair Campbell/New Labour Derangement Syndrome? I thought this disease had run its course?, but I guess like swine flu it will always be with us.

  • Trevor Malcolm, Portsmouth Hampshire

    T O P F I V E E C O N O M I C S P I N T I P S

    SIR: Now you’re aged 52 years, welcome to a workforce of 20 million other chaps over 50, also members of this elitist group, still grinding out a day job, of sorts

    Why not invite us all to retire early? Today, for example? Let the Government seduce us with a one million quid severance pay for each good chap, maybe on stress-related health grounds

    Because it’s that fresh crop of job vacancies, why, ‘twould solve the country’s unemployment problem, that’s for sure

    Second, with our fistful of banknotes, we must all commit to buying a new, British car. Hardly ideal, and I don’t suppose for a moment the Campbells of Gospel Oak would ever be seen out driving one. But those 20 million cash orders for British cars soon sorts out the UK’s troubled automobile industry, see?

    Third, our free million quid handouts allow each of us to purchase a posh, luxury apartment, overlooking Port Solent – hence, the phrase “affordable housing” – and thus, for the good of the country, easing the Housing Crisis

    Even the most jaded Estate Agent will then espy the ” … green shoots of recovery” that Government ministers have long promised us

    Fourth, these 20 million new millionaires must force their offspring from school into colleges and Uni, ie into educational, productive activities, not criminal, not drug-related activities

    Finally, – fifth – make us codger Nouveaux Riches shell out over fifty quid minimum every week on alcohol and tobacco. Yes, you heard me

    This daily chain-smoking and binge-drinking allows the Government to claim its Treasury monies back through duty, tax, etc. For spin-tips, how’s that sound, turnips?

    One last resort, to top up any Treasury shortfall, insist ministers pay back in full falsely-claimed expenses and second-home allowances. Then, replace MPs pensions and resettlement payoffs, with the Severe Arse Whippings they so richly deserve

    Some good, old-fashioned, traditional discipline needed in Parliament, there. Humph, all this political deviousness, it didn’t happen in my day



  • ian mcpherson

    Great to hear your presentation to the NHS Confederation, particularly as you had a packed house of senior NHS managers most of whom would have never come to a mainstream mental health event, as they need to register the impact of the “disease prestige” league table and work out how the NHS can tackle this.

  • Catriona Smith

    Hi AC! Good blog as usual…Just one point to make, which is whenever illness strikes, no matter what it is, you want YOURS to be the number one priority for a)the medical staff who are dealing with you and b) the Government to fund. My husband had a ‘myocardial infarction'(heart attack) in Nov,despite being extremely fit( a black belt in karate,into Tai Chi etc.) and with NONE of the risk factors usually involved. The cause was put down to the fact that we had had several bereavements the preceding year plus my husband is a teacher who has been teaching for 35 years, with the stresses that involves. His treatment was excellent and I could not fault the NHS, nor could I fault their treatment of my late Mother for lung cancer and a brain tumour. I guess the point I’m making is that there shouldn’t be league tables at all. If something’s sore, you want it fixed as soon as possible and if someone you love is suffering, it’s more unbearable to watch than if it was yourself suffering the pain (in my experience). So I guess I’m saying we need more funding for all. It shouldn’t be down to who can argue the best. (Though I’m sure it’s just that!)The really chilling part of your piece was when you said that geriatrics was down there near the bottom. When you think of the babyboomers who are going to be getting old in the next ten years…..Shudder….