Serious Mental Health Problems in the Community: Policy, Practice, and Research

By Charlie Brooker; Julie Repper | Go to book overview

CHAPTER 3
Purchasing Mental
Health Services

Edward Peck


KEY ISSUES

INTRODUCTION

The aim of this chapter is to introduce the role of purchasers of mental health services (Health Authorities, Social Services Departments and GP Fundholders) and map the development of purchasing of mental health services in the UK since 1989. This evolution has had cultural, structural and clinical implications which will be explored; but it is the cumulative effect of these implications that this chapter will seek to demonstrate. Given the breadth of the field and the limited space available, references will point to accessible sources of further reading.

The publication of Working for Patients (Department of Health, 1989a) and Caring for People (Department of Health, 1989b) ensures that 1989 will be remembered as a watershed in the development of the organisational arrangements within which mental health services are provided. One of the major purposes of the proposals contained in the White Paper was to challenge the cultural assumptions which guided managerial and professional behaviour in health and social services; although the exact nature of that cultural change was always difficult to predict. Roger Freeman, then Under Secretary of State at the Department of Health, admitted as much when he acknowledged that he had no idea what health services would look like in 1995 (Peck, 1996).

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