Not for the first time, I find myself wondering exactly which planet Ed Miliband inhabits.
In his first major speech since the Labour Party conference he said that, just as Disraeli addressed the national challenge of sanitation in the 19th Century, and the foundation of the NHS followed in the 20th Century, the mental health challenge facing the UK must be addressed this century.
“One in four of us will have a mental illness at some point in our lifetime,” he also said.
He said, too, that, while mental illness blights the lives of billions it’s “costing UK business £26bn and the NHS an extra £10bn a year” a clearer indication, perhaps, of where his priorities really lie, and therein lies the problem.
The fact is that if the scourge of mental illness is to be addressed in anyway way seriously, bitching about money from the outset is the wrong approach – this is not a problem that can be fixed with parsimony. Treating mental illness properly will probably cost the NHS more, not less.
And – something he chose to ignore – improving the lot of the mentally ill will not be helped by an NHS that is being fragmented and privatised, especially the latter. Psychiatry is expensive and, unlike, say, surgery, the returns are far less tangible and take far longer to achieve. It will not be popular with new owners driven by the search for profits.
Better drugs are needed, too. I’m occasionally plagued by depression – many people who are chronically sick are – and the drugs don’t work. Tricyclics shut down my depression by the simple but unacceptable expedient of shutting down my brain to the point at which I can barely function, while SSRIs cause me to cough uncontrollably, until my lungs haemorrhage. It’s no surprise to me that people who are far more seriously afflicted sometimes won’t take their meds.
Drugs are needed that target a condition more precisely, while not massively screwing up the patient with adverse side effects. Is that actually possible? I don’t know, but psychotherapeutic drugs have changed little over the years, the choice is still mainly tricyclics or SSRIs for the commonest condition, depression, so there is clearly room for improvement.
There’s a problem, though. Developing a new drug from the basic theory to safe for humans can take years, and many millions of pounds and, not unreasonably, drug companies want to see a return on their investment, so new drugs are expensive, and thus unlikely to be approved by the bean-counters at NICE unless they offer a substantially improved outcome compared to existing drugs. So, unless Miliband, if he ever comes to power, is willing to accept that trying to solve the problem of poor mental health on the cheap is never going to happen, I have no idea where he’s going with this.