New Script for Mental Health has written to the Health Committee to raise grave concerns regarding the failures in regulatory oversight of Community Mental Health Services and to ask the Committee to urgently scrutinise these matters. Those concerns relate both to the specific case of Gareth Waterworth, in which egregious human rights breaches continue to occur, as well as to the wider issue of RQIA’s ongoing failure to regulate these services.

On 10 May 2023, in a Judicial Review, the High Court directed the Regulatory and Quality Improvement Authority ( RQIA) to inquire into the treatment of Gareth Waterworth, a 36-year-old brain damaged man, by the Northern Health and Social Care Trust (NHSCT).  In 2016 the NHSCT had agreed a 24/7 care package for this vulnerable man, before denying it to him, without explanation.   One year since that Judicial Review  ruling, the RQIA still has not completed an investigation and Gareth Waterworth still does not have a care package.

That Judicial Review, taken by Gareth Waterworth’s uncle and sole carer, Mr. Paul Herbert, also exposed that the RQIA had failed to regulate Community Mental Health services for 14 years. It had not undertaken any reviews or inspections of Community Mental Health Services provided by Health and Social Care Trust, despite a legal duty to do so.FOI data obtained by PPR from all five Health and Social Care Trusts indicates that in 2023 alone approximately 42,000 people accessed community mental health services, so aggregate numbers impacted over those 14 years must run into several 100,000s.  These individuals accessed a wide range of mental health services in the community, including community mental health for adults and for older people, forensics, eating disorder, addictions, and personality disorder, all of which are effectively unregulated.

The RQIA has stated that inspections of Community Mental Health Services are in response to ‘intelligence’ received by services, stakeholders, and requests from the Department of Health. Since May 2023, a total of ten concerns were raised with the RQIA. None of these was raised by service users and only two by a relative or friend. It is entirely unrealistic and wrong to expect that service users, their relatives or friends will raise concerns, given the lack of knowledge, the vulnerability, and the fears of victimisation of service users. The RQIA has indicated that it is developing a protocol, due to be published at the end of June 2024, to enable it to “examine issues of concern about possible detriment in care and treatment for patients living in the community, in their own home or with family”.

Aside then from the concerningly slow pace of work in establishing a protocol, given the widespread lack of confidence in the RQIA in relation to mental health,  it is critical that there is external scrutiny of any such protocol being developed.

The RQIA does not have a good track record on ensuring participation of service users and their families around services. In 2009 they committed to establishing two external reference groups to “…ensure a clear user and carer voice, two external reference groups will be established that will include service users, carers and advocates representing the respective interests of mental health and learning disability.”An FOI response to PPR from RQIA revealed that those groups were never set up. Aside then from the concerningly slow pace of work in establishing a protocol, given the widespread lack of confidence in the RQIA in relation to mental health,  it is critical that there is external scrutiny of any such protocol being developed.

All the matters above were previously raised with both the Minister for Health and the Health Committee by Mr. Paul Herbert and by Mrs. Mary Gould, a mother who lost her 21-year-old son Conall due to failures in care by the NHSCT. The Health Committee must urgently investigate these failures, starting with the Department of Health, where its role is to hold the Department to account.