Dear NHS Scotland and NHS Wales… This is an NHS UK Crisis!

Dear Caroline Lamb/Judith Paget,

I am hopeful that you have already engaged with the material attached to the first email of this thread (the initial delivery and handover of the crisis in question: no regulated dual-diagnosis treatment, care and recovery pathway, as delivered on 1^st May 2024).  I am not certain anybody has picked this up and moved with it because no one is responding to emails yet, not even parliament, and it has now been over two full weeks since the formal handover of this crisis took place.

I am forwarding the communication sent to Amanda Pritchard, Chief Executive of NHS England, for one reason, I cannot keep writing the same thing, and there is much that is important for you to know in the email.  I have been hounding the NHS for close to 5 years now (4 in writing), and something has to change for the patient before my world can be restored to what it was before NHS-negligence-by-proxy ended my young, beautiful life as I knew it.  I have had years stolen from me.  It took three family members censored censored censored during the years of deliberate NHS negligence, and the damages resulting directly from the total abandonment of a patient’s medical needs, well, they are abhorrent and must come to be counted, remedied, and avoided by NHS UK in the future.

In the end, the only reason many NHS staff members did their jobs is because I had to force them to do it by scaring them with ultimate consequences.  Half of the time, staff did not believe that I would follow through with my ‘promises’ (I never make threats, they are empty, I always tell people what I will do, but they never trust I have the gall or guts) and they still broke the law (in full awareness and after fair warning).  To me (and The Justice System, I feel certain), they are criminals, and their imprisonment and loss of medical licences is all that I will feel to be justice; it may take years, I do not care.  These ‘professionals’ knew exactly what they were doing and they did not care for the patient’s wellness, safety or medical truth, as the evidence can reveal instantly.

Alas, after 5 years of staring death in the face and fighting like hell, I am scared of nothing.  I lost it all already, even my health and capacity to work.  So yes, I am ready to battle to the death, not of any human, but to fight to kill the cold, heartless system that is fully harming vulnerable clients of The State, as well as their carers.  I have been writing letters for over 4 years now, I am well practiced, and the next collective of recipients will be The United Nations and UK Human Rights Organisations, who I feel will be interested in the evidenced and visible breaches of human rights legislation, even more so, should zero safeguarding measures be taken by the NHS and the government herein. 

In truth, I live on the hope that the NHS will respond with action, and determine to meet the needs of a vulnerable group within the realms of regulated, safe, ethical practice.  The risk to life is too great to ignore, Madam, and with your staff now potentially discharging unsafely, and within your realm of full awareness, well, I trust you see your own duty of care here and I do not need to be crass about it.  I do not know you and I can appreciate this is out of the blue, but for me, it is the conclusion to a long, harsh war, fought, but not yet one, for my loved one is still being treated unsafely and unethically in an unsuitable, underqualified paradigm; is there anything not negligent about that?  Can the same not be said for the rest of the dual-diagnostic patient demographic in the UK who dwell in the unknown waters of unregulated practice, as they struggle for breath and drown before their loved ones’ eyes?  That is the consequence to zero NHS intervention, which one would expect to begin with a plan of similar strength to, The Manifesto (see email at the beginning of this thread, sent to parliament and NHS Chief Executives, which is now formally readdressed to you).

Should you speak with Ms Pritchard, I feel certain she will confirm, having hopefully engaged with the material on the RIO entry system, that a number of Human Rights violations have occurred for the patient and family, and for that, I seek ultimate justice, and I will not stop until I do.  This must be known, for I will not disappear, just ask censored NHS Foundation Trust, who spent years ignoring me, thinking that was an okay thing to do… imagine how they must feel once justice comes to meet them where they stand… in ignorance, an unsafe perspective, and a criminally negligent paradigm.  Other professionals stand there too, I will find their victims eventually, and this will all come raining down.  It is up to the NHS whether it rains down with more injuries, damages, and lives lost, or just with the injuries of censored censored censored. 

The way I see it, the NHS could be seen to be responsive to the crisis after being enlightened to it, via, Manifesto for Change: Dual-Diagnosis and Disparity.  Or, Chief Executives and Governing Boards can ignore me too (just like the last NHS Chief Executive I asked for such help from did; who knows what will happen to his career once this all comes to light), and thus ignore an entire vulnerable groups’ medical needs, and therefore, their Human Rights to safety, health, treatment, dignity, independence, and more (there’s always more). There can be no other reason than ignorance, prejudice, bias and stigma deciding the fates of roughly 80% of acute ward psychiatric inpatients, those known to have the comorbid diagnosis in focus (remember, A&E will be turning patients away at the glance of a blood test result because of their harmful prejudices too, so the numbers are almost certainly higher).  80%, that’s a lot of patient needs to ignore, a heck of a lot.  And so, when I ask you to help, I am also asking who you now choose to be, a professional who clings to the lies told through stories of the past… or a revolutionary who sees truth, science, reality, and chooses to fight for the law to be upheld for ALL of those they have a duty of care to see healed and recovered from life’s darknesses?

Science can attest to the neurological, physiological, genetic nature of addiction, when that diagnosis comes with a primary disorder of psychosis, PTSD, depression, bipolar, or even acute anxiety, then dual-diagnosis becomes treatable under The Mental Health Act, it has been that way since 1983 (who knew, definitely parliament, did you too?).  To deny the right to a dual-diagnosis treatment pathway is to deny lawful outcomes for around 4/5 of patients admitted into Mental Health Trusts for treatment and care (including as an outpatient, a client of The State who has the same right to a treatment outcome of stable, sustainable, long-term recovery from dual-diagnosis).  My case is no isolated incident, as is confirmed by the huge numbers of carers making complaints, calling for help, all while being ignored, just like my family were.

This problem will continue to grow, it will not shrink, and I do feel, vehemently, that my job as advocate should be done.  I suppose, as usual, that is up to the NHS!  My life is in your hands now, and it cannot take much more ruin, for there may already be no path back to full health for me, what with there being zero proven-to-be-effective treatment, care and recovery support pathways for my loved one (or me, apparently).  In such a way, my own Human Rights have been violated, as I was forced to endure the literal torture of watching a family member decline and inch towards death (unnecessarily and avoidably), when all they needed was to be safely detained and treated for dual-diagnosis (censored censored censored censored censored censored censored).  Censored censored censored censored censored, and no practitioner has yet impressed me with their comprehension of their comorbidity, or capacity to censored censored treat the patient.  I do feel that every professional, to date, has been supremely unqualified to do the job safely, ethically, and thus, lawfully.

I hope this can all change, for my family, as well as the other, potentially thousands of patients, waiting for this necessary, life-saving, already legislated treatment, care and recovery support pathway to come to full fruition.  Please note, the patient I write for is a client of NHS England, but according to the CQC, neither NHS Wales or NHS Scotland have regulated Dual-Diagnosis pathways either. This is a UK mental health complex treatment and care crisis, one both parliament and the NHS are contracted to resolve, if they are to avoid further loss of life and sanity.  I do hope the handover is soon acknowledged and taken as seriously as it must be.  Lives must come to be counted soon too, of those already disabled and left to die by a negligently practicing NHS system. 

I have the evidence backing up my claims, I will encourage the public to stock pile their evidence too, because these stories matter and must come to be told.  Moreover, thinking ahead, to not empower the public to ask for newly arriving, accessible, life-saving help (when it finally arrives), it is akin to the negligence I have already witnessed (some of which would count as Gross-Negligent Manslaughter, had the outcome been ‘death’ instead of ‘damage’), and I do expect to see the public enabled towards the safeguarding of their poorly loved ones in due course (perhaps in the same fashion as the fear-mongering Covid new reports). 

Many parents, siblings, adult children, and perhaps even infants, are witnessing terrifying declines into psychotic illness and dual-diagnosis, which NHS responsible clinicians refuse to treat safely because of their own prejudice and bias.  I have not once seen treatment refused because data accessed viaclinical assessment and thorough diagnostic procedure thought it the right call.  It has always been negligence, prejudice, and perhaps laziness.  When A&E staff see a positive drug test in any patient, many just move straight to discharge.  They, evidentially, do not care why 999 was called or what was happening to their patient in the family home or the community, and these unsafe discharges will need to be counted too, with the public’s help.  This is the pattern, many do not even make it onto the acute wards, meaning the statistics could be far worse than I fear.  Potential deaths could be in their thousands eventually, something we can prove once family’s learn how to record everything in real time, which I have already started teaching them to do via the website, Anamaria.org. [see free letter templates here, in the ‘free chapter downloads’ section].

I am as determined as I was on the day I set out on this journey, back in 2020 when I asked for a referral to a dual-diagnosis pathway (in writing).  Here we sit in 2024, as I come to realise I was lied to, regularly, for there isn’t one… is there???  I fought hard enough to know it, now it is time for NHS UK to admit to their failings and save the lives they have been failing to save, for many years.  The rest doesn’t matter, for now.  I will chase the evidence after the people presently dying have their right to life fulfilled.  Ultimately, I pray that senior leaders invite such knowledge about the services they are responsible for managing, and I can only hope that you, and every other responsible party, delves into investigating everything fully, transparently, and with a public call for feedback from the carers most of all (and any patients in recovery from dual-diagnosis, if there is one).

Yours faithfully,

Ana Maria Santuario.

p.s. Download the letter and disseminate it to raise awareness:

p.p.s. Faith in Change Publishing are launching with 12 Collective Social Anthologies. You may download the letters inviting The People of the UK to write for their health, safety and freedom, here: