Councillor’s call for Health Board to better fund children’s mental health support

A local county councillor has called on the Powys Teaching Health Board to provide more funding and support for children with complex mental health issues after it was revealed that the County Council is facing a huge overspend this year.

Powys County Council Cabinet meeting this week considered a report on the pressures across Children Social Services, where a proposal to virement (transfer) of funds into the children's service budget was considered.

The report highlighted that Children Services is reporting a forecast end of year position of an overspend of £1.854 million.

Trewern Councillor Amanda Jenner, the Chair of Powys’ Health and Care Scrutiny Committee, spoke at the Cabinet meeting to put across the Scrutiny Committee's perspective as her committee had raised a number of concerns and questions about the overspend.

The main questions raised concerned the detail and breakdown behind the overspend and why some financial pressures referred to in the virement report were not eligible for Welsh Government Covid Grants.

Speaking at the meeting, Cllr Jenner said: “Since Scrutiny's comments, the Committee has been briefed by the Children's Department, primarily to provide the detail behind the increased expenditure.

“The committee was informed about a small number of children with some of the most complex needs. We were told that despite the children's team working around the clock to try and find suitable affordable registered placements for these children, this has been impossible and registered settings have not been able to offer placements due to the complex needs of these children.

“In addition, we were made aware that all local authorities are competing for the same type of provision, as is widely known, there are insufficient placements on a national scale.

“We were informed that some of Powys’ children are now in court endorsed unregistered placements which are highly expensive.

“It is fair to say that the councillors were shocked by the case backgrounds and the high level of costs involved.

“In particular, councillors on the committee heard of a court endorsed multi-agency decision for round-the-clock mental health nursing care for one child. This mental health support has been organised, resourced and paid for by the Council and is costing in the tens of thousands a week, making up most of the increased expenditure.

“This mental health cost is on top of other social care costs involved in this case, which are also being incurred by the local authority.

“My Scrutiny Committee asked why the local Health Board has not organised, resourced and paid for this mental health care rather than the Council having to use an agency.

“We were informed that despite considerable and on going efforts by the Local Authority Children’s Team, the Health Board has not been forthcoming with this. 

Expressing her concern over this, Cllr Jenner added: “Social care and mental health care are two separate things. I thought we were moving to an era where medical organisations treated mental health with parity to physical health. If this is not so, this is very worrying. I will be inviting the Health Board to come to my scrutiny committee in order to discuss both collaborative working and in particular to hear about the mental health support which they provide to our children in Powys.”

Cllr Rachel Powell, Cabinet Member for Young People, Culture and Leisure noted: “I am very thankful for Cllr Amanda Jenner’s comments, which mirror the alarming reactions from scrutiny members.

“Scrutiny’s observations are significant and encapsulate the harsh realities and challenges, that as a Children’s service we are experiencing.

“It is with disappointment that our health partners remain unwilling to support an improved model of care for young people with complex needs, requiring therapeutic support, in collaboration with Children’s Services.

“Our Young People who are children looked after, deserve better. This is not only having an impact on those individuals lives, but also creates unnecessary barriers for operational staff, trying to support them, leading to significant financial implications for the service.”

A decision was approved unanimously by cabinet for funding transfers up to a maximum of £1.854 million from the Councils Budget Management Reserve to cover the shortfall. It will go to a full council meeting to be decided.

Following the meeting, a spokesman for Powys Teaching Health Board said: “We continue to work with in partnership with PCC so that together, we ensure that children and young people in Powys receive care that is safe and effective.”