In its NHS Plan the Government makes proposals for greater and deeper user involvement in the National Health Service. This is undoubtedly an important exercise in democracy and ought to be welcomed for that alone. However, it seems to be based on an assumption which most of us know to be untrue – that there are a whole lot of people just waiting to become involved. It is no less true in health than it is in anything else. People are not that interested in taking on responsibility and jobs which require them to give up substantial periods of their free time and for which there is no financial reward.

The level of community involvement is usually quite low unless there is a particular reason which galvanises people into action. Crises unite people and allow them to work for a common cause. In the ordinary day-to-day existence, this seldom happens. Whilst we are all proud of our democratic heritage, how many of us bother to watch it in action – go to Council Meetings, attend briefings? All too few.

The new Camden & Islington Mental Health Trust will be required to set up a Patients Forum and Patients Council (not to be confused with those already in existence) composed of the users of its services, and it will also need to have a PALS (Patients Advocacy & Liaison Service). There will be an opportunity for someone to sit on the Trust Board to represent users of its services. There may even be a possibility that she/he could Chair the Trust and this would be a first for the statutory sector since there are no non-user groups in the voluntary which currently have service users as their Chairs.

All this seems likely to put heavy demands on that small minority of people who are prepared and able to be involved and it does not do service to the lady who wrote ‘when I am well, I want to forget about being ill’.

This year the South Camden User Forum has begun to develop more effectively and part of the reason for this may be that it now has a fixed time, date and base – 5.30 p.m. on the last Tuesday of the month at Jules Thorn Day Unit. We have also tried to provide a wider range of subjects and speakers. It is has moved away from the period when the attendance was so poor that we thought that we might have to abandon SCUF altogether, and it will have another role to play if the idea of developing user involvement on a Borough Forum model becomes a reality. Already there is an offer for two people from SCUF to attend the South Camden Locality Management Advisory Group.

The February meeting brought along Saimo Chahal, a partner with the solicitors Bindman & Partners, whose speciality is mental health work and who also sits as Chairman of a Mental Health Review Tribunal. She therefore sees the picture from both sides. She talked about the relationship between the Mental Health Act and the Human Rights Act and how the latter was likely to affect the position of detained patients. She also talked about the proposals in the Government’s White Paper ‘Reforming the Mental Health Act’ which was intended to lay some of the groundwork for the debate that will take place on the afternoon of Tuesday, 27 March at Hampstead Town Hall.

Because Tuesday, 27 March is being given over to the User Review/Mental Health Act Debate, there will not be a SCUF in March since it would have fallen on the same day.

April’s SCUF will be on Tuesday 24 at Jules Thorn Day Unit and will bring along a CMHC member, Kate Crosby. Kate works as an advocate in another London Borough and has also co-authored a book on the subject ‘Power Tools’. She will be talking about the subject of advocacy and empowerment.

This meeting attracted the usual good audience that NCUF has developed and there was an interesting discussion with several points of personal concern raised and dealt with. The meeting was intended with its SCUF twin to lay some of the groundwork for the Mental Health Act Debate on Tuesday, 27 March.

April’s NCUF will be something of a miscellany. Robin Gandy is coming along to talk about ‘fitness and mental health’. Robin is a fitness instructor locally and has a special interest in this aspect of overall health. Keith Russell, the Assistant Locality Director (Health) for North Camden Mental Health Service has promised to come again and talk about the development of Patients’ Councils at RFH in-patient units and the Felix Brown and Fordwych House Day Hospitals. The Development Workers who have been carrying out the Camden Crisis House Research are going to come and tell people what it has been like as service users taking the views of other service users and presenting them in a report, which may influence the shape of any development of a Crisis House in Camden.

It is often difficult to decide what subjects people would like to have discussed at meetings and how these particular meetings can be made to fit more within the role of user involvement which is being proposed for them. So one of the questions that we will be asking at the next meeting is ‘What do you want these meetings to be like and how do you see them fitting in to the wider picture?’

The terminology has changed quite a bit over the months since the Adult Mental Health Strategy was introduced and the ‘Quadrants’ have become ‘Localities’ and their ‘Quadrant Managers’ the ‘Locality Directors’. There is a Locality Director for North Camden, Tony Ewart, and his counterpart in South Camden, Colin Plant. These two men are responsible for the Adult Mental Health Services in Camden in their Localities and manage both the Health and Social Services components. The Headquarters of North Camden Mental Health Service is for the moment The Royal Free Hospital and for South Camden Mental Health Service, St Pancras Hospital. The new Camden & Islington Mental Health Trust will have its base at St Pancras Hospital and so both Locality Directors may become based there or there may be a different arrangement – this is currently being worked out. The management structure of the new Trust might mean further changes and provide new opportunities.

The Locality Management Advisory Groups are the mechanisms by which the Locality Directors and their senior management teams are enabled to look critically at the various parts of their operations with a variety of other parties, including service users, local councillors, carers, voluntary organisations and the Community Health Council. Although each Locality has an LMAG, they are not mirror images of each other.

NCamden LMAG

This group meets four times a year and is chaired by the Locality Director, Tony Ewart. It met in March at the newly reopened Hoo Building in Lyndhurst Gardens which is becoming the HQ of the NCamden Community Mental Health Teams. The first open part of the meeting was to hear from service users and members of staff who use/are part of the CMHTs. Unfortunately there were no service users and only one staff member to talk to the LMAG.

At one of its previous meetings the LMAG considered Day Hospital provision when there was strong input from service users on the plan to close Felix Brown Day Hospital and transfer its patients to Fordwych House. At another, it looked at in-patient provision and considered questions like the daunting nature of the ‘ward round’ and access to information. At both these meetings there were service users to talk to the meeting and pre-LMAG meetings had been arranged to collect their views.

The next LMAG meeting will review both its composition and work and try and decide what route forward this group should take and how it links

In with the other various groups/forums/meetings that already exist and any others that are going to be developed. This will be particularly important with the new C&I Mental Health Trust and may mean that there is more consistency across Camden and Islington and possibly that the wider District perspective becomes more important.

SCamden LMAG

The South Camden LMAG meets five times a year and is currently Chaired by Gareth Pountain, Chief Executive of Umbrella.

The last meeting of this LMAG was a The Huntley Centre and it was interested to see what the in-patient provision there is like, how it compares with the old Huntley Centre in the West End and what benefits developments like the Advocacy Service have brought.

Previously this LMAG has visited St Luke’s Woodside Hospital to look at the rehabilitation ward there; Mind in Camden’s Day Centre; St James’s House; and Jules Thorn Day Unit. In all cases it has had the opportunity to hear from service users and this has been an important part of its proceedings. Through the meeting at the Jules Thorn Unit, it was able to bring about changes in the environment and in the facilities made available to the JT Patients’ Council.

At its next meeting it is hoping to hear something about the forensic psychiatric services that are provided within and for Camden.

Camden Council Social Services

Last time this group met at ORT House it heard about Democratic Renewal and what that meant for groups like itself.