South Worcestershire's health chiefs have made the decision to scrap the region's counselling service to cut costs. They admit this could lead to more people being prescribed anti-depressants. Worcestershire's counselling agency warns that the consequences of this decision could be dire for the county's mental health.

IN recent years, counselling has become established as a valued service - by doctors and patients alike - in the majority of GP surgeries in the Worcester and Wychavon areas.

For patients, one of the great advantages has been its availability in a place familiar to them - the GP surgery. It is also, of course, free at the point of delivery through the NHS.

Counsellors in GP surgeries see patients who bring a whole range of issues including depression, anxiety, stress, relationship difficulties, bereavement and loss, and so on.

The latest figures suggest that 25 per cent of us can expect to suffer from depression at some point in our lives.

More and more people these days would prefer not to be given medication and, instead, are prepared to try to understand the underlying causes of their difficulties, thereby becoming stronger and more in control of their lives.

It is in this context that South Worcestershire Primary Care Trust, despite acknowledging that "patients are generally satisfied with counselling", has made its decision to abolish this service as part of its package of savings aimed at achieving "financial balance".

Of course, we understand that the finances of the trust are in a dire state. Savings have to be made and it is not an enviable position to have to make choices and decisions that inevitably affect people's lives.

If counselling is not axed, savings will have to be made in another area. We are not oblivious to this and, if savings have to be made, fully accept that the counselling service has to share the pain.

However, we are left with a sense of anger and grievance largely because of the process by which the trust has made its decision. The dictionary suggests that consultation means "to seek information or advice, to reflect and take into consideration".

Obliged to enter into a period of consultation, SWPCT have given every impression of going through the motions of listening to representations, while making it perfectly clear they had no intention of moving an inch.

In this day and age, you might have thought that patients' views counted for something.

Apparently not.

Faced with a petition signed by 1,300 people opposing the abolition of GP-based counselling and many letters from patients in support of the existing service - 10 per cent of whom indicated that they would not be here but for the counselling they received - SWPCT has stubbornly stuck to its original plans.

They eventually met with counsellor representatives two days before the end of the consultation period. The opening comment of the chief executive at this meeting was: "This is a listening exercise and we will not be answering any questions because the consultation period is not yet complete".

The likely consequences of removing counselling from surgeries? Patients will attend with greater frequency to see their GP and more medication will be prescribed at ever-greater cost to the NHS. In other words, it is likely that overall costs will increase.

Where will people go for help if not to GP-based counsellors?

You might expect that GPs will be able to refer more people in need to the psychiatric and psychological services but they cannot cope at present and often send referrals back to GPs (for counsellors to see!)

Besides, these services are generally for those with more severe mental health problems, are far more expensive than primary care counsellors and suffer from the stigma inevitably associated with what is seen as a "mental illness" service.

The other alternative is to pay privately for counselling. Therefore, counselling is likely to become the privilege of those who can afford to pay.

It does not appear that SWPCT has any coherent plans to put an alternative service in the place of GP-based counselling.

What ideas it has seem to be based on a psychologist and a couple of new graduate mental health workers.

It is difficult to comprehend how it will manage to provide an effective service across 31 surgeries.

We are very concerned about the apparent vacuum that will be left.

We accept that counselling is not for everyone and there is ongoing debate about its usefulness but patients generally like it and doctors generally support it.

SWPCT, however, have made up their mind!

- This article was signed by the following members of Worcestershire Counselling Agency - Mike Parmenter, Tim Young, Caroll Murphy, Anne Cunningham, Jennifer Higgins, June Moore, Angela Gerrard, Sarah Winterbourne, Angela Townsend, Sue Cockeram and Rose Ling.