Learning from the NHS Internal Market

Abstract

The history of the care of the mentally ill is full of examples of the unintended consequences of what were thought to be humane policies. The enlightened asylums of the nineteenth century became the inhumane psychiatric institutions of the twentieth century. The move from institutions to the community was done for the best intentions, but in some countries many of the most disabled fell through holes in services. Is there a danger of unintended consequences in following a disability and rights model in the care of those with a mental health problem? If there is, they could arise with a reluctance by professionals to accept responsibility for care when faced with a person who does not want help. They could also arise if, in pursuit of rights, lawyers rather than health professionals determine what is appropriate care for those with a mental health problem. These misgivings aside, Rachel Perkins and Julie Repper have produced a most valuable and thought-provoking book which deserves to be read by all those with an interest in mental health and mental health problems. Not least of the benefits of this book is the extensive bibliography provided.

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