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NHS England psych bed shortages kill nine

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Frazers
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NHS England psych bed shortages kill nine

Postby Frazers » Fri Nov 28, 2014 2:48 am

http://www.bbc.co.uk/news/uk-30236927

Seven mental health patients have killed themselves in England since 2012 after being told there were no hospital beds for them, the BBC has learned.

An investigation of coroners' reports and NHS trust papers with the journal Community Care found another patient denied a bed later killed his mother.

It comes as mental health beds are being cut in England - figures show more than 2100 have gone since 2011.

The NHS England said spending on mental health was increasing in real terms.

The investigation by BBC News and Community Care has also revealed an email that a chief executive of a mental health trust wrote to NHS England in frustration this summer after one of her senior officials came to tell her that: "Yet again there were no mental health beds in London in either the NHS or private sector."

Wendy Wallace, head of Camden and Islington NHS Foundation Trust, bemoaned NHS England's lack of interest in the problem. She wrote: "I could not envisage a situation where all the acute beds in London were full and there was not even an investigation into the situation nor a plan of action."

The investigation established that since 2012 seven people across England have taken their own lives having been told no beds were available. They were:

Pauline Binch, 64, from Nottingham
Stephanie Daniels, 32, from Manchester
Michael Knight, 20, from Norfolk
Mandy Peck, 39, from Essex
Anthony Quigley, 53, London
Terence Mullin, 53, from Liverpool
An unnamed man from Sheffield
In addition, Peter Holboll from London admitted the manslaughter of his mother, Tamara, having been told no beds were available.

A ninth person, Amanda Vickers, 47, from Cumbria, died after being denied a bed in a crisis house, a facility used to treat patients outside hospitals.

Pauline Binch, from Nottingham, started to develop mental health problems in 2010. The 64-year-old took an overdose in June, July, August and September 2013.

Following the fourth attempt to take her life, on 24 September her psychiatrist said that an inpatient admission was required and a request was sent to a bed manager.

No bed was available between 24 and 29 September. On 30 September a bed did become available but the trust could not contact Pauline and that evening the bed was given to another patient. A bed was not found on 1, 2 or 3 October.

At 20:45 BST on 3 October, Pauline's body was discovered at her home.

The investigation into her death concluded: "Bed managers were aware of the severity of risk in PB's case but (with the exception of several hours on 30 Sept 2013) could not find a bed to admit her to." Her husband John told the BBC "she'd still be alive today if they'd found her a bed".

New figures, revealed through freedom of information requests from 52 of England's 58 mental health trusts, show that since last August a further 468 beds have been cut.

That means that since April 2011, when there were 18,924 beds available, a total of 2,179 beds have been cut.

Other data from the trusts show that the wards that remain are over-occupied.

Adult acute admission wards are running at an average monthly occupancy level of 101% for the past two years.

The Royal College of Psychiatrists says the occupancy level should be 85%.

It is possible for trusts to exceed 100% as they fill beds temporarily freed-up when patients are allowed out for a short time although filling those beds runs the risk of no bed being available if the patient on leave has a relapse.

Ms Wallace said: "If you need admission to a mental health bed, your need is very high.

"Unless we get some attention, unless we get some understanding of what's happening in the system, and some resources to be able to deal with it, it won't improve."

Flagship policy
Much of the anger within the mental health system is directed towards NHS England which is accused by many of failing to understand or prioritise mental health.

Last year, they suggested to clinical commissioning groups, who buy mental health services, that they cut budgets to mental health trusts by a greater percentage than for physical health hospitals.

The Department of Health and the care and support minister Norman Lamb MP are putting much hope for a change in mental health provision on the Mental Health Crisis Care Concordat - their flagship policy for improving care.

But just a month before a deadline for areas to sign up to the agreement, just one third of areas have done so while just 6% have announced plans on how they will put it into practice.

Mr Lamb said: "We've made huge progress but we want to go further to make sure everyone gets the care they need and to ensure that mental health gets treated fairly in the allocation of resources.

"We are going further than ever before to put mental health on a par with physical health."

NHS England's director for people with long-term conditions Dr Martin McShane said: "Spending on mental health is now going up in real terms after years when services were under real pressure.

"One result [of the increase in spending] is big falls in the number of people in mental health crisis ending up in police cells.

"As we expand services patients are also able use NHS-funded beds in the independent sector.

"But the-long term solution is not just about beds, or buildings, as highlighted in Sir Stephen Bubb's recent report, but about finding the right solution for each patient."


This is utterly disgraceful. Mental health across the entirety of the UK (not just England) is failing patients and placing both them and the public at risk from violent psychiatric behaviours. There is a serious need for increased funding of mental health services but i'm just not sure where it's going to come from and until such time as that can be achieved we need to ensure more efficient management of patients so they can be safely removed from existing beds at the earliest and safest time. However, until improvements can be made we're going to be stuck with a sorry state of affairs.

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Postby Risottia » Fri Nov 28, 2014 3:08 am

Frazers wrote:
The Beeb wrote:It comes as mental health beds are being cut in England - figures show more than 2100 have gone since 2011.


Cameron's "big society" at work. Not a big surprise. It's just Thatcherism 2.0 .
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Postby Tierra Prime » Fri Nov 28, 2014 4:17 am

Those who are responsible for this have blood on their hands. And it's not just mental health facilities that these cuts impact.

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Postby Napkiraly » Fri Nov 28, 2014 5:03 am

Risottia wrote:
Frazers wrote:


Cameron's "big society" at work. Not a big surprise. It's just Thatcherism 2.0 .

I'm actually going to say that Cameron is worse than Thatcher.

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Postby Lordieth » Fri Nov 28, 2014 5:10 am

Title is somewhat misleading. The bed shortages didn't kill them. They killed themselves. It's also very difficult to say with certainty that the bed shortage was the cause of their deaths. These were mentally ill people.

This seems like a correlation vs causation issue. Because an event happened, and then another event happened, doesn't mean one event caused the other. The bed shortage situation is serious. As are mental health issues. But I'm not sure this data is reliable. Not to make light of any of these problems, but I don't see how they could say that the bed shortages caused these deaths. Attributed to? Quite possibly. Caused? No.
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Postby Herskerstad » Fri Nov 28, 2014 5:22 am

Lordieth wrote:Title is somewhat misleading. The bed shortages didn't kill them. They killed themselves. It's also very difficult to say with certainty that the bed shortage was the cause of their deaths. These were mentally ill people.

This seems like a correlation vs causation issue. Because an event happened, and then another event happened, doesn't mean one event caused the other. The bed shortage situation is serious. As are mental health issues. But I'm not sure this data is reliable. Not to make light of any of these problems, but I don't see how they could say that the bed shortages caused these deaths. Attributed to? Quite possibly. Caused? No.


I would also be surprised if this is the only time the last administration there has been shortages. Even here in Norway where we got advanced logistics with a relatively low population, we still get sometimes hospitals having people sleep on the floor in hallways in hospitals and such.
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Postby Frazers » Fri Nov 28, 2014 5:35 am

Herskerstad wrote:
Lordieth wrote:Title is somewhat misleading. The bed shortages didn't kill them. They killed themselves. It's also very difficult to say with certainty that the bed shortage was the cause of their deaths. These were mentally ill people.

This seems like a correlation vs causation issue. Because an event happened, and then another event happened, doesn't mean one event caused the other. The bed shortage situation is serious. As are mental health issues. But I'm not sure this data is reliable. Not to make light of any of these problems, but I don't see how they could say that the bed shortages caused these deaths. Attributed to? Quite possibly. Caused? No.


I would also be surprised if this is the only time the last administration there has been shortages. Even here in Norway where we got advanced logistics with a relatively low population, we still get sometimes hospitals having people sleep on the floor in hallways in hospitals and such.


Sleep on the floor in hospitals? Jesus Christ

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Postby Frazers » Fri Nov 28, 2014 5:37 am

Lordieth wrote:Title is somewhat misleading. The bed shortages didn't kill them. They killed themselves. It's also very difficult to say with certainty that the bed shortage was the cause of their deaths. These were mentally ill people.

This seems like a correlation vs causation issue. Because an event happened, and then another event happened, doesn't mean one event caused the other. The bed shortage situation is serious. As are mental health issues. But I'm not sure this data is reliable. Not to make light of any of these problems, but I don't see how they could say that the bed shortages caused these deaths. Attributed to? Quite possibly. Caused? No.


They died due to their mental illness which the NHS has a duty to treat just as someone refused a bed for pneumonia would have died due to their physical illness were they refused a bed. It's despicable that you treat mental and physical illness so differently with the former being their own doing when I highly doubt you would do the same with the latter.

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Postby Lordieth » Fri Nov 28, 2014 5:44 am

Frazers wrote:
Lordieth wrote:Title is somewhat misleading. The bed shortages didn't kill them. They killed themselves. It's also very difficult to say with certainty that the bed shortage was the cause of their deaths. These were mentally ill people.

This seems like a correlation vs causation issue. Because an event happened, and then another event happened, doesn't mean one event caused the other. The bed shortage situation is serious. As are mental health issues. But I'm not sure this data is reliable. Not to make light of any of these problems, but I don't see how they could say that the bed shortages caused these deaths. Attributed to? Quite possibly. Caused? No.


They died due to their mental illness which the NHS has a duty to treat just as someone refused a bed for pneumonia would have died due to their physical illness were they refused a bed. It's despicable that you treat mental and physical illness so differently with the former being their own doing when I highly doubt you would do the same with the latter.


That's not the same thing at all. I've actually suffered with serious mental depression myself, so please don't make aspersions about what I think about mental illness, because you've entirely missed my point. If someone doesn't get treated for a physical illness that could kill them and they die, then yes you can directly attribute that to not getting treatment.

Now prove the refusal of the bed is what caused that mentally ill person to kill themselves. You can't. Not unless they explicitly stated it. This isn't about stigmatising the mentally ill. It's about correlation and causation. There's a massive bed shortage. Many people are refused beds. Nine deaths correlated to bed shortages is statistically insignificant. This has nothing to do with mental illness. It's to do with statistical insignificance of a small sample data. I'm not arguing against treating the mentally ill. I'm pointing out that the conclusion is misleading. The conclusion is flawed, because the deaths can't be correlated to the bed shortages, and the amount of bed shortages vs the amount of deaths makes it even harder to draw any conclusions that it was the bed shortage that caused these people to kill themselves.

It's a serious issue, but the report is misleading. Regardless of whatever the issue may be, there is no excuse for providing misleading conclusions.
Last edited by Lordieth on Fri Nov 28, 2014 5:47 am, edited 2 times in total.
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Postby Frazers » Fri Nov 28, 2014 5:50 am

Lordieth wrote:
Frazers wrote:
They died due to their mental illness which the NHS has a duty to treat just as someone refused a bed for pneumonia would have died due to their physical illness were they refused a bed. It's despicable that you treat mental and physical illness so differently with the former being their own doing when I highly doubt you would do the same with the latter.


That's not the same thing at all. I've actually suffered with serious mental depression myself, so please don't make aspersions about what I think about mental illness, because you've entirely missed my point. If someone doesn't get treated for a physical illness that could kill them and they die, then yes you can directly attribute that to not getting treatment.

Now prove the refusal of the bed is what caused that mentally ill person to kill themselves. You can't. Not unless they explicitly stated it. This isn't about stigmatising the mentally ill. It's about correlation and causation. There's a massive bed shortage. Many people are refused beds. Nine deaths correlated to bed shortages is statistically insignificant. This has nothing to do with mental illness. It's to do with statistical insignificance of a small sample data. I'm not arguing against treating the mentally ill. I'm pointing out that the conclusion is misleading. The conclusion is flawed, because the deaths can't be correlated to the bed shortages, and the amount of bed shortages vs the amount of deaths makes it even harder to draw any conclusions that it was the bed shortage that caused these people to kill themselves.

It's a serious issue, but the report is misleading. Regardless of whatever the issue may be, there is no excuse for providing misleading conclusions.


In pneumonia it wouldn't be the refusal of a bed that killed them it would ultimately be the pneumonia. The NHS however has a duty of care to prevent that happening. If they don't then they have for all intents and purposes caused the death of the patient through neglect.

In mental illness it wouldn't be the refusal of a bed that killed them it would ultimately be the mental illness. The NHS however has a duty of care to prevent that happening. If they don't then they have for all intents and purposes caused the death of the patient through neglect.

Having had a mental illness yourself doesn't preclude you from making stupid statements about them sadly.

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Postby Lordieth » Fri Nov 28, 2014 6:10 am

Frazers wrote:
Lordieth wrote:
That's not the same thing at all. I've actually suffered with serious mental depression myself, so please don't make aspersions about what I think about mental illness, because you've entirely missed my point. If someone doesn't get treated for a physical illness that could kill them and they die, then yes you can directly attribute that to not getting treatment.

Now prove the refusal of the bed is what caused that mentally ill person to kill themselves. You can't. Not unless they explicitly stated it. This isn't about stigmatising the mentally ill. It's about correlation and causation. There's a massive bed shortage. Many people are refused beds. Nine deaths correlated to bed shortages is statistically insignificant. This has nothing to do with mental illness. It's to do with statistical insignificance of a small sample data. I'm not arguing against treating the mentally ill. I'm pointing out that the conclusion is misleading. The conclusion is flawed, because the deaths can't be correlated to the bed shortages, and the amount of bed shortages vs the amount of deaths makes it even harder to draw any conclusions that it was the bed shortage that caused these people to kill themselves.

It's a serious issue, but the report is misleading. Regardless of whatever the issue may be, there is no excuse for providing misleading conclusions.


In pneumonia it wouldn't be the refusal of a bed that killed them it would ultimately be the pneumonia. The NHS however has a duty of care to prevent that happening. If they don't then they have for all intents and purposes caused the death of the patient through neglect.

In mental illness it wouldn't be the refusal of a bed that killed them it would ultimately be the mental illness. The NHS however has a duty of care to prevent that happening. If they don't then they have for all intents and purposes caused the death of the patient through neglect.

Having had a mental illness yourself doesn't preclude you from making stupid statements about them sadly.


Oh, so the NHS is responsible for watching someone with a mental illness 24/7, and if they don't, they're ultimately responsible for their death? Now who's making stupid statements.

You're conflating a serious issue with the inability to see the difference between cause and effect. The bed shortages may have attributed to some of these deaths, but to say it caused them is ridiculous. What if they got the beds, but then killed themselves the next day? What would we blame it on then? The quality of the bed? If you can't understand that seven deaths across the entire english NHS correlated to bed shortages is statistically insignificant, then I' can't explain it to you in simpler terms. You're placing blame on something there is no evidence for. Just poorly correlated data.

http://en.wikipedia.org/wiki/Correlatio ... _causation
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Postby Frazers » Fri Nov 28, 2014 6:25 am

Lordieth wrote:
Frazers wrote:
In pneumonia it wouldn't be the refusal of a bed that killed them it would ultimately be the pneumonia. The NHS however has a duty of care to prevent that happening. If they don't then they have for all intents and purposes caused the death of the patient through neglect.

In mental illness it wouldn't be the refusal of a bed that killed them it would ultimately be the mental illness. The NHS however has a duty of care to prevent that happening. If they don't then they have for all intents and purposes caused the death of the patient through neglect.

Having had a mental illness yourself doesn't preclude you from making stupid statements about them sadly.


Oh, so the NHS is responsible for watching someone with a mental illness 24/7, and if they don't, they're ultimately responsible for their death? Now who's making stupid statements.


I'm going to stick with it being you. Strawman arguments have that effect.

You're conflating a serious issue with the inability to see the difference between cause and effect. The bed shortages may have attributed to some of these deaths, but to say it caused them is ridiculous. What if they got the beds, but then killed themselves the next day? What would we blame it on then? The quality of the bed?


If they killed themselves as an inpatient then yes I certainly would blame the quality of the inpatient ward.

If you can't understand that seven deaths across the entire english NHS correlated to bed shortages is statistically insignificant, then I' can't explain it to you in simpler terms. You're placing blame on something there is no evidence for. Just poorly correlated data.

http://en.wikipedia.org/wiki/Correlatio ... _causation


These were 9 patients who were assessed by trained professionals who stated a need for a bed due to serious mental illness. The bed could not be found and in the period of bed searching these patients had a fatal result. Nine patients were failed by an NHS service which is operating significantly beyond it's operating capabilities.

I understand the cult-like devotion to the NHS these days given perceived privatisation attacks on it but this isn't one of those cases. Both private and public beds are overwhelmed and the duty is on the NHS to correct for that.

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Postby Lordieth » Fri Nov 28, 2014 6:30 am

Frazers wrote:
Lordieth wrote:
Oh, so the NHS is responsible for watching someone with a mental illness 24/7, and if they don't, they're ultimately responsible for their death? Now who's making stupid statements.


I'm going to stick with it being you. Strawman arguments have that effect.


Frazers wrote:The NHS however has a duty of care to prevent that happening. If they don't then they have for all intents and purposes caused the death of the patient through neglect.


Strawman indeed.

You're conflating a serious issue with the inability to see the difference between cause and effect. The bed shortages may have attributed to some of these deaths, but to say it caused them is ridiculous. What if they got the beds, but then killed themselves the next day? What would we blame it on then? The quality of the bed?


Frazers wrote:If they killed themselves as an inpatient then yes I certainly would blame the quality of the inpatient ward.

Completely missing the point, again. If these people weren't in the care of the NHS, and it can't be proved that the denial of a bed was the reason they killed themselves, then how can you blame the NHS?

If you can't understand that seven deaths across the entire english NHS correlated to bed shortages is statistically insignificant, then I' can't explain it to you in simpler terms. You're placing blame on something there is no evidence for. Just poorly correlated data.

http://en.wikipedia.org/wiki/Correlatio ... _causation


Frazers wrote:These were 9 patients who were assessed by trained professionals who stated a need for a bed due to serious mental illness. The bed could not be found and in the period of bed searching these patients had a fatal result. Nine patients were failed by an NHS service which is operating significantly beyond it's operating capabilities.

I understand the cult-like devotion to the NHS these days given perceived privatisation attacks on it but this isn't one of those cases. Both private and public beds are overwhelmed and the duty is on the NHS to correct for that.


And you have the gaul to accuse me of a strawman argument? Please.
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Postby Frazers » Fri Nov 28, 2014 6:33 am

Lordieth wrote:
Strawman indeed.


Yours was, mine wasn't. Simple

Completely missing the point, again. If these people weren't in the care of the NHS, and it can't be proved that the denial of a bed was the reason they killed themselves, then how can you blame the NHS?


These people were in the care of the NHS. One doesn't have to be on NHS property to be in the care of the NHS. They were assessed by mental health practitioners, deemed in need of a bed, and due to the systems inability to find said bed they were negligently cared for.


And you have the gaul to accuse me of a strawman argument? Please.
[/quote]

That's still not a straw man. Are you sure of the definition here?
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Postby Lordieth » Fri Nov 28, 2014 6:37 am

Frazers wrote:
Lordieth wrote:
Strawman indeed.


Yours was, mine wasn't. Simple

Completely missing the point, again. If these people weren't in the care of the NHS, and it can't be proved that the denial of a bed was the reason they killed themselves, then how can you blame the NHS?


These people were in the care of the NHS. One doesn't have to be on NHS property to be in the care of the NHS. They were assessed by mental health practitioners, deemed in need of a bed, and due to the systems inability to find said bed they were negligently cared for.


And you have the gaul to accuse me of a strawman argument? Please.


That's still not a straw man. Are you sure of the diagnosis here?


Again, you're still not proving the bed shortage caused the death, which is an unproven correlation which is statistically insignificant given the amount of suicides and amount of bed shortages in the UK, let alone a single NHS trust.

You clearly insinuated a "cult-like devotion to the NHS", which is a strawman argument. Again, still entirely missing the simple point that yes, it's a serious issue, but no, you still can't attribute all these deaths to being refused a bed.
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Postby Fartsniffage » Fri Nov 28, 2014 6:37 am

Frazers wrote:If they killed themselves as an inpatient then yes I certainly would blame the quality of the inpatient ward.


I think this might be a better thing to be looking at. The story in the OP talks about 9 deaths over 2 years. Check out the numbers in this one...

http://press.labour.org.uk/post/9589308 ... -nhs-wards

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Postby Lordieth » Fri Nov 28, 2014 6:38 am

Fartsniffage wrote:
Frazers wrote:If they killed themselves as an inpatient then yes I certainly would blame the quality of the inpatient ward.


I think this might be a better thing to be looking at. The story in the OP talks about 9 deaths over 2 years. Check out the numbers in this one...

http://press.labour.org.uk/post/9589308 ... -nhs-wards


That's good data. It's correlated. As I keep trying to point out, the data provided by the story in the OP is not correlated.
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Postby Dumb Ideologies » Fri Nov 28, 2014 6:40 am

The NHS is creaking under the weight of a plethora of useless management consultants, shitty lowest-bidder sub-contractors and government unwillingness to make proper investments rather than shuffling the deckchairs in the direction the boat is already sinking in another pointless "reform". Next term they'll probably hive the whole thing off to G4S or ATOS.
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Postby The Nihilistic view » Fri Nov 28, 2014 6:43 am

Fartsniffage wrote:
Frazers wrote:If they killed themselves as an inpatient then yes I certainly would blame the quality of the inpatient ward.


I think this might be a better thing to be looking at. The story in the OP talks about 9 deaths over 2 years. Check out the numbers in this one...

http://press.labour.org.uk/post/9589308 ... -nhs-wards


Well at least they are killing themselves instead of letting Labor try to cover up deaths from poor care directly. So it's an improvement.
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Postby Patriarch » Fri Nov 28, 2014 6:45 am

Lordieth wrote:
Fartsniffage wrote:
I think this might be a better thing to be looking at. The story in the OP talks about 9 deaths over 2 years. Check out the numbers in this one...

http://press.labour.org.uk/post/9589308 ... -nhs-wards


That's good data. It's correlated. As I keep trying to point out, the data provided by the story in the OP is not correlated.


The data Fartsniffage gives though comes from a fairly dodgy source in the debate though.

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Postby Fionnuala_Saoirse » Fri Nov 28, 2014 6:47 am

Aye shit's fairly fucked. More importantly it's irritating as fuck to me when I give a recommendation that someone be admitted due to risk of harm to self and/or others and i'm pressured by bed managers not to admit. I really don't want to end up going through a court process because the powers that be won't shell out for more beds. Also irritating is the geographical distances patients are sent. In many cases I could secure a voluntary admission if a patient was admitted in their area but when the prospect of being transferred 60 miles down the road comes up they're no longer willing to come in and an unnecessary involuntary detention is the result.
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Postby Lordieth » Fri Nov 28, 2014 6:48 am

Patriarch wrote:
Lordieth wrote:
That's good data. It's correlated. As I keep trying to point out, the data provided by the story in the OP is not correlated.


The data Fartsniffage gives though comes from a fairly dodgy source in the debate though.


The labour party? They sourced it from the mental health trusts. Labour do have a biased interest in criticising the NHS under the Conservatives, but still, that doesn't make the data they obtained dodgy.
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Postby Patriarch » Fri Nov 28, 2014 6:50 am

Lordieth wrote:
Patriarch wrote:
The data Fartsniffage gives though comes from a fairly dodgy source in the debate though.


The labour party? They sourced it from the mental health trusts. Labour do have a biased interest in criticising the NHS under the Conservatives, but still, that doesn't make the data they obtained dodgy.


It does. Without access to the freedom of information request, raw data and a proper report to review their methodology the press release isn't worth the digital paper it's printed on.

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Postby The Nihilistic view » Fri Nov 28, 2014 6:52 am

Lordieth wrote:
Patriarch wrote:
The data Fartsniffage gives though comes from a fairly dodgy source in the debate though.


The labour party? They sourced it from the mental health trusts. Labour do have a biased interest in criticising the NHS under the Conservatives, but still, that doesn't make the data they obtained dodgy.


I would be hesitant to take it as gospel when there are no citations and a lack of any real detail.

And anyway perhaps they have gone up as Trusts have actually started releasing data properly now that Labour aren't there trying to cover stuff up.
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Lerodan Chinamerica
Minister
 
Posts: 3252
Founded: Dec 31, 2012
Ex-Nation

Postby Lerodan Chinamerica » Fri Nov 28, 2014 8:00 am

bloody thatcher

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