The current issues around funding the NHS threaten to halt the progress made on mental health during the coalition government.
One in four people in the UK experience a mental health problem each year. According to the Mental Health Foundation, 70 million work days are lost per year in the UK due to mental illness, making it the leading cause of absence from work. Place2Be, a children’s charity, recently published a survey showing that 63% of children at primary school worry “all the time” about at least one thing to do with their school life, home life or themselves. How we treat mental health in the UK is therefore no small issue. And yet, as the care crisis in the NHS rages, mental health is once again falling down the list of government priorities as it so often has done in the past.
During the coalition government, some steps forward were taken. Not only was mental health routinely discussed and brought up in speeches by ministers, but tangible policies were put in place to start to address the lack of parity between physical health and mental health. Notably Norman Lamb, a Liberal Democrat MP, spearheaded several initiatives whilst he was the Minister of State for Care and Support.
Among other initiatives, the Health and Social Care Act in 2012 placed a new legal framework on the NHS to deliver “parity of esteem between mental and physical health” with 2020 being set as the target for when parity would be reached. In 2014, the first targets were set on waiting time standards for some mental health services. The Crisis Care Concordant, launched in February 2014, improved inter-agency working, resulting in a significant drop in the number of people being detained in police cells during mental health crises.
However, there is a danger that this progress is halting, and even beginning to reverse under the current government, as the care crisis takes hold. Mental health no longer seems to be a high priority. There have been no major policy or funding announcements on mental health since Theresa May became prime minister. When responding to parliamentary questions the government merely restates previously announced schemes.
Funding is a major problem. Mental health problems account for 23% of the burden of disease, but only receive 13% of NHS funding. Much of mental health funding, including the coalition government’s flagship programme IAPT (Improving Access to Psychological Therapies), is not ring-fenced meaning it can be used to subsidise other under pressure services if local decision makers feel this is appropriate.
Research undertaken by the Healthcare Financial Management Association recently revealed that only half of the 32 mental health trusts they spoke to had received a real-terms increase in their 2015-2016 budgets, with just 25% saying they expected NHS clinical commissioning groups (CCGs) to increase the value of their contracts for the 2016-17 financial year. After decades of underinvestment in mental health services this is simply not good enough. Promised funds are not getting through to local mental health services as mental health becomes overshadowed by other health crises and NHS decision makers are forced to firefight, rather than make strategic decisions. These are worrying developments for mental health care in this country.
So although progress has been made over the last decade to improve mental healthcare, we are a long way from achieving parity with physical illness. To continue the coalition government’s progress, this government needs to wake up and not allow mental health to get lost in the myriad of other illnesses afflicting the NHS. Mr Hunt, in particular, needs to step up to the plate.