AT THE end of April an inquest jury ruled that a patient who died after admittance to a privately owned psychiatric hospital near Weston Super Mare had received “gross failures” in her care. 

Lily Lucas, a 28-year-old former mental health nurse, collapsed in Cygnet Healthcare’s Kewstoke hospital, and died the next day in Bristol Hospital, where she was taken after her collapse.

Lucas had complex and serious mental health difficulties which led to her death. But the “understaffed” Cygnet ward did not help: Lucas was drinking excessive amounts of water as part of her disturbance, which can be very dangerous. 

But among the “missed opportunities” to prevent her death, the jury found Cygnet staff did not recognise her “psychogenic polydipsia” — the disturbance leading to drinking too much water — or her deteriorating mental health or provide adequate urgent medical attention when she collapsed with a seizure and a heart attack.

The bulk of NHS mental health hospital care has been privatised and Cygnet is a major player in the business. This is far from the first time it has been found taking the money for poor services. 

In September 2023 Cygnet was fined £1.53 million over a patient’s death in London. The Care Quality Commission prosecuted Cygnet because it did not take the right steps to prevent a young woman committing suicide in Cygnet Hospital Ealing. 

The commission said Cygnet didn’t properly prevent the use of ligatures or observe patients often enough or train staff how to revive patients properly.

£1.53m is a big fine, but would it worry Cygnet? Its latest annual report says the firm gets £170.5m a year. The firm says it “relies on publicly funded entities in the UK for substantially all of its revenues.” All of that £170.5m comes either from the NHS or local authorities, who pay for their psychiatric hospitals and homes for kids and adults with learning disabilities.

Cygnet is owned by a US healthcare giant Universal Health Services, which runs around 200 psychiatric hospitals and centres in the United States. I think many people in Britain are simply unaware that a US private health firm is running great swathes of privatised NHS mental healthcare. If they knew more about Universal Health Services, they’d be appalled.

In 2020 the US Department of Justice fined Universal Health Services $122m (£97.5m) for “for billing for medically unnecessary inpatient behavioral health services, failing to provide adequate and appropriate services, and paying illegal inducements to federal healthcare beneficiaries.” 

The fine was imposed after Universal Health Services own nurses protested outside the firm’s HQ in Pennsylvania. The nurses said that the firm systematically held patients longer than necessary to maximise revenues. The nurses said the firm held patients until the “last covered day” — the longest period US government-run health insurance schemes like Medicare or Medicaid would pay for, regardless of whether the patient was recovered and ready to leave. 

US officials also found the firm ran units that were understaffed, with staff who were undertrained, as has been found with Cygnet. But the systematic holding of patients who were ready to leave, on apparently spurious diagnoses, is a particularly US wrinkle.

Will Labour get water firms to clean up their act?

SOME were shocked when Labour MPs voted for the government to reduce the power of the water regulator — but if they read what the Labour Party is saying, they shouldn’t be surprised. 

At the end of April the Tory government imposed a new “growth duty” on water regulator Ofwat. This means Ofwat must “have regard to the desirability of promoting economic growth” when cracking down on water companies. 

This duty means that Ofwat will have to think about how to preserve or increase water firms’ profits when it regulates or considers fines, to the water firms. 

The water companies have been making big profits by allowing pollution to spill into our rivers and the sea. So this duty will mean that Ofwat won’t be able to force the water companies to stop polluting if the firms say this will stop their “growth.”

The Lib Dems tried to organise a vote against the government’s new growth duty. They expected Labour to join them. Keir Starmer has junked Labour’s old policy of renationalising the water firms, but his shadow team have promised they would give the regulators more powers to try press the water firms to stop pouring filth into the rivers instead. 

However, Labour MPs didn’t even stick with this weak alternative to nationalisation. Instead, Labour MPs voted with the Tories. Sources told the press they did this because they didn’t want to be accused of being “anti-growth.”

However, as readers of this column know, Labour actually decided to push regulators like Ofwat to put water companies’ profits first, before the Tories’ latest move.

In February Labour got formerly Tory lobbyist Iain Anderson to write a “business review.” I read the report — although I suspect many lobby journalists didn’t bother — and it made very specific nobble-the-regulators recommendations. 

Anderson’s official Labour Party review says a Labour government should stop the “significant regulatory ‘creep’ seen in Britain since 2016.” 

Ministers should listen to “highly regulated” firms and then have more “high-level engagement between government and the country’s systemic regulators, to take place regularly.”

Anderson is saying government ministers should press regulators to be softer on “highly regulated” firms — like private water companies.

Anderson says there would be “significant political and practical benefits from all regulators having to take into account the ‘real economy’ impacts of its decision-making — for example, providing assessments of impacts across the labour market, economic growth, and investment decisions at a regional and sectoral level.” 

Anderson was, in an official Labour report, pushing for the “growth duty” before the Tory Party introduced it into Parliament, so it is not surprising Labour MPs voted with the Tories and their attempt to further hobble the water regulator.