Labour have long wanted to reform the Mental Health Act, and made their first attempt with the Mental Health Bill 2002, which failed rather spectacularly. Several further attempts have also proved fruitless. But now they’re having an all-new attempt at reforming the Act.

Firstly, in true modern NHS style, it now means that the range of people empowered to do things is vastly extended. Where the power to detain people and force treatment upon them was previously restricted to a select few with the necessary skill and experience, the Government now wants to extend this power to a great many more people – in fact, pretty much anyone who claims to work with the Mental Health sector who’s been on a short course. And it will be the Social Service – not medics – who decide if someone can be deemed to be an Approved Mental Health Professional.

This is nurse-prescribing gone mad. Of course, Mental Health nurses have long been highly trained in the detention of individuals for short periods, and they play a very important role in this arena. But now the government wants to open this up to any Mental Health professional. Dodgy counsellors will no medical training will soon be able to sign up for a course, then will be able to detain people. That sounds unhelpful.

Just to make it even easier for these poorly trained individuals to know who they can round up, the Government would like to change the definition of a Mental Disorder. Instead of detailed definitions of each kind of disorder, the Government now wants us to accept “any disorder or disability of the mind” as a definition. This is beyond stupidity. Now, anyone who has epilepsy or has suffered a stroke or has any number of conditions suddenly falls under the provisions of the Mental Health Act, and the mountains of bureaucracy that entails. I’m sure that’ll come as a particular delight to overworked GPs, general physicians, and mental health workers nationwide.

And, ho-hum, they feel a need to better regulate these powers. So they’re introducing much greater use of Mental Health Tribunals. Anyone who’s ever tried to organise a Tribunal for a patient will know that it’s damn-near impossible, so to use more of them seems – well, not a great idea.

Yet this stinking piece of terrible legislation is getting very little media coverage because of public embarrassment about Mental Health.

There is one glimmer of hope – It’s hard to deny that most of the Cabinet have “disorders of the mind”, so we can wait till they pass the new legislation, then lock the lot of ’em up. If Yates of the Yard doesn’t get there first…

To all those people that are complaining about Patricia Hewitt distancing herself from the recent (predictable) problems with Modernising Medical Careers, and saying she’s hiding behind Lord Hunt – you’re missing the point. She doesn’t care.

Patricia Hewitt has said publically that she thinks the NHS has too many doctors and nurses. If doctors are choosing to go abroad – good riddance! That’ll help to balance the books, so Ms Hewitt can pay for more managers.

After all, if doctors are starting to complain about things, then something’s clearly wrong: They’re not being worked hard enough if they have time to make a fuss. We clearly need more managers.

A true landmark vote in the Commons tonight gave a result that surprised many – including Iain Dale, Dizzy, and (errr) me. A vote in favour of a 100% elected House of Lords. Of course, quite how (if?) that’ll work remains to be seen, and it’s not quite what I would’ve gone for, but it’s probably a positive move. Are we on the brink of true bicameralism?

An interesting, but much more parochial landmark also passed tonight – over 100,000 spam comments caught by Akismet on this blog alone. Again, I’m not quite sure what that means for the future of humanity, but it’s interesting. On the one hand, it shows that spam is well and truly alive – but the fact that the filter caught it shows that their tactics aren’t quite so strong any more. It’s an interesting dichotomy – an increase in spam being used to mark its decline.

I’ve uploaded more stuff over on the Work pages for the first time in a while. I think it’s worth highlighting this piece, about the public health effect of speed cameras, which I think from previous posts that some of my readers might find interesting. It’s hardly crucial seminal research, but I think some people might find it an interesting read.

So there you go – three utterly different topics in one barely coherent post. It’s a while since I’ve done that.

The BBC’s Cash for Honours injunction has been lifted – no doubt there will be more on the One O’Clock news and The World at One. Tune in now!

The Attorney General is a government appointee. He attends Cabinet Meetings, and is a very political figure. Indeed, Lord Goldsmith is a Labour peer.

Simultaneously, the Attorney General has supervisory powers over prosecution. He is the chief legal advisor of the Crown. He (largely) calls the legal shots in this country.

Now, his two worlds have spectacularly collided, and this staunch Labour supporter is being asked to preside over the case of corruption within the Labour Party. If that’s not a major conflict of interest, I’m not sure what is. Yet he refuses to step aside and ‘butt out’ of this affair, despite the fact that any fool can see that him being involved is not in the interests of true Justice being done.

The Government continues to use the slightly meaningless defence that “it’s always been that way” – well, yes, but never have we seen corruption to the heart of the governing Party quite like we have at the moment. It’s a new situation, and as new situations arise our uncodified Constitution is able to adapt – this is, and always has been, its great strength. Its great weakness is the virtually unchecked power handed to the Government of the day, and perhaps this is something that needs to be reformed in the world of corrupt politics.

Lord Goldsmith will be the last Attorney General of his kind. This situation has destroyed the credibility of the office. I’m not sure why, but that just feels like a significant blow in the downfall of the Labour Party: A 730 year old office falls apart because of the corruption of one small group of people.

I’m not sure whether to be depressed at the erosion, or to celebrate the wonderful versatility that this country’s unique constitution provides. It’s probably not for me to judge. But it seems worthy of a mention.

The Attorney General has obtained an injunction against the BBC, preventing it from broadcasting an item about the Cash for Honours inquiry. Obviously, this isn’t something I’m ‘in’ on. But with a little summation, it’s not difficult to work out what’s going on.

Iain Dale reveals this much:

So this now leads the BBC Ten O’Clock News but Nick Robinson can’t say what the injunction is all about. Let me help. I understand it is to do with an email that incriminates someone in a fairly drastic way. I do not know what the terms of the injunction are, but isn’t this an injunction which the Labour Party should have asked for rather than Her Majesty’s Government?

I am aware of the identity of the individual who is the subject of the email, but I think if I name them I’ll probably be banged up at Heathrow on my return! And, dear reader, you wouldn’t want that, would you?!

A quick look at Guido’s labelling, and the picture the BBC originally put up with it’s report, and I’d imagine we know fairly well where we are.

It’s starting to get exciting.

Tessa Jowell promised Parliament and the country that the cost of hosting the Olympics would likely be £3.6bn – and, just to be sure, she’d plan for it to cost up to £4.5bn, as there was a ‘risk’ that it ‘might’ end up costing that much. But, throughout the bid process, she assured us repeatedly that the plans were properly costed, and that she had planned for all eventualities. The budget would not be overrun in the way that almost all public project budgets do, and to the extent that most modern Olympic budgets do. If just couldn’t happen, because Tessa had done her sums perfectly.

Now we’re told that it will cost up to £9bn. That, as Ms Jowell may or may not realise, is significantly more than she said it would cost. She promised us all that the extensive work she’d done would mean that this wouldn’t happen. Yet it has. And, predictably, Ms Jowell hasn’t planned for it.

Experts predicted that the Olympics would cost much, much more than Ms Jowell’s predictions. She dismissed them, saying that she knew best. She didn’t. Now she’s in a sticky situation. Maybe she should resign. Not that it would achieve much, but it would be a recognition that she’s not delivered. But since when did ministers resign over matters of policy? With the honourable exception of the late Robin Cook, that’s just not the New Labour way.

The New Labour way is to grab a mug of tea, take the happy pills, and try to embarrassingly ‘engage’ with the public at large. Hazel Blears would fit right in as Deputy Leader. She’s exactly the kind of self-obsessed, perma-smile, flower-on-the-lapel, own-world-reality New Labour idiot that seems to gratify Westminster’s New Labour idiots right now.

[flashvideo filename=”http://sjhoward.co.uk/video/blears.flv” title=”Hazel Blears does YouTube” /]

For the good of the country, I hope Gordon Brown doesn’t go soft. New Labour needs a good boot up the backside, and he could be just the guy to provide it. But Hazel Blears is hardly the sidekick he needs.

Tony Blair’s appearing on the Today programme’s 8.10 interview again tomorrow. It’ll probably be as cringeworthy as usual, but worth a listen.

Logging on to the Irish Labour Party’s election campaign site, I can’t be the only one who expected some sort of punch line.

For a decade and a half, our economy has boomed. There are more jobs and there is more money … But, are you happy?

It’s a campaign that’s so bizarrely terrible that it almost makes you wish for the lies and dirty tricks of British politics. Almost.

The OFT published a much journalised report earlier this week about how the NHS is spending far too much on branded drugs. It’s a frustrating report, because they so nearly got to the point of the issue, but not quite.

Their problem is, effectively, that people are being prescribed branded drugs which are no more effective than non-branded generic versions. This is probably true in a minority of cases. But in many cases, the drug brand does make a difference. It shouldn’t, but it does. Let me provide a couple of examples.

First, the technical one. There is a wealth of evidence that different brands of identical epilepsy drugs have different effects. The reasons are unknown – and, in a world of evidence based medicine where we do what works rather than understanding what works, they are likely to stay that way. So in this case, the spend on the branded drug may well be justified. This is one example that springs to mind, there are probably many others.

Secondly, the prosaic reason. Believe it or not, medicine in a person works better than medicine in a cupboard. Quite often, for their own bizarre reasons, patients won’t take generic medications, but prescribe a branded version, and they’re quite happy. This is, perhaps, more common in kids where there is a choice between the generic flavourless version and the branded flavoured version. If the medication is necessary, then it’s necessary to get it into the patient. If that means prescribing a more expensive version because the patient is awkward, that’s sometimes justifiable too.

But more than this, the overspend on drugs has little to do with branded drugs. They so nearly hit the mark when they said the system should be changed “to deliver better value for money from NHS drug spend and to focus business investment on drugs that have the greatest benefits for patients”. So close, and yet so far.

You see, a great number of the drugs we pump into people have no effect. This isn’t because doctors are cruel, it’s because this is (or so it would seem) what the government wants. If your blood pressure is 139/89, you won’t get pills. If your blood pressure is 140/90, you might well do. You’re not at a hugely increased risk with an increase of 1mmHg, but the Government has decreed that patients above an arbitrary hypertension cut-off must receive treatment to prevent some of them developing future complications. There’s very little judgement in this on the doctor’s part – an untreated patient is a failure, even if the doctor’s best judgement suggests they shouldn’t be on treatment. And this story is repeated over countless conditions with countless protocols. We’re spending money on drugs that even the doctor often feels are unnecessary.

There are a whole host of other areas in which the NHS overspends on drugs, too. Drugs which patient’s use to decorate their kitchen cupboards; drugs which are on repeat prescription but never used; drugs prescribed “because” a person has free prescriptions, which cost very little in a chemist; drugs prescribed (sometimes understandably) to get patients off doctors’ backs.

Branded medications are the tip of a very large iceberg, much of which is controlled by a Government who insist on telling doctors what to prescribe, and to whom, rather than letting their years of clinical judgement be used to their full extent.

Perhaps one day, someone will actually get round to taking the NHS in hand, and righting the wrongs. Perhaps. But for the moment, it seems the powers that be are content to tinker around the edges of huge problems in a massively frustrating way, whilst avoiding the real issues and the difficult decisions. No politician wants to ‘re-educate’ patients on the things they do wrong in their interactions with the NHS, because the punters are the voters. Nobody wants to look weak by admitting past failings and correcting them. Nobody wants to actually fix the problems.

But surely someone can see that the deckchairs have been re-arranged enough, and that HMS NHS needs some urgent upward motion? Or should I find myself a life-raft now?