By John Kapp, meditation leader and former heartsink patient and councillor, of 22, Saxon Rd Hove BN3 4LE, 01273 417997, 23.6.14
firstname.lastname@example.org Social Enterprise Complementary Therapy Company (SECTCo)
sectco.org.uk , and section 9 of reginaldkapp.org
1. Summary – 3,000 mindfulness courses for 30,000 depressed patients on vouchers
I have written this proposal for Dr Tom Scanlon (director of public health) hoping that he will include it in the Wellbeing Strategy for the city, to be presented to the next meeting of the Brighton and Hove Health and Wellbeing Board on 29.7.14.
I have been campaigning for GPs to be able to prescribe NICE-recommended Mindfulness Based Cognitive Therapy (MBCT) 10 week meditation courses as easily as Prozac for the 30,000 depressed patients in the city, for which they have the statutory right under the NHS constitution. This would require the commissioning of 3,000 courses pa, assuming 10 patients per course, costing £23 mpa, which is half the prescribing budget, and about 3% of the council’s budget.
Many of these patients are known as ‘heartsinks’ because the doctor’s heart sinks when he sees them because he knows there is nothing he can do for them. All they can be given is drugs which get them further addicted, and perpetuates their habitual merry-go-round use of primary care, A&E, social services, housing, unemployment, criminal justice etc, costing the taxpayer on average an estimated £10,000 each pa, which is largely wasted because nobody gets better from it.
This paper proposes to increase the social capital in the city by diverting half the prescribing budget (£55mpa) to finance specialist meditation centres near surgeries, to which GPs could refer their heartsink patients by prescription voucher for meditation courses. Each of the 47 surgeries in the city should commission and provide about 60 MBCT courses pa for 600 heartsink patients, most of which should be provided at these new meditation centres.
These new meditation centres would be set up to effectively address all the social determinants of the wellbeing of heartsink patients, namely housing, education, self care, employment, social care, and health. The MBCT and other courses there would give them a safe space and structure to learn how to look after themselves, and replace their disfunctional habits with functional ones.
GPs at each surgery would prescribe on average 60 courses pa for 600 patients pa, costing £475,000 pa, or £800 per patient treated for up to 90 hours (£9 per hour).
We estimate that this £23 mpa invested would save £172 mpa (£7.50 saved per £1 invested) in avoiding un-necessary patient contacts, hospital admissions, and attendance in public housing, employment, benefit, and criminal justice systems. This would pay back the investment in 7 weeks, and accrue a total saving to the taxpayer of £1,720m over 10 years.
It would also increase the social capital in the city, rejuvenate derelict shops, and create 750 full time jobs, and volunteering opportunities for nearly 4,000 of our citizens. By 2020 the public health statistics could be halved and 20% less cost to the taxpayer, as described in previous papers.
You are invited to view by arrangement SECTCo’s model meditation centre at 3, Boundary Rd Hove BN3 4EH (near the corner of Kingsway). It is about 400 yards from Portslade Health Centre, which we hope will refer patients to it, and typifies what each of the 47 GP surgeries in the city should have.