At last, the promise of hard cash to meet the needs of mental health services. David Cameron has promised a “mental health revolution”, with a £1 billion annual injection for health services by 2020. As we know, mental health services are chronically underfunded – so this is welcome news.
Or is it? Consider if you will the financial pressures facing the NHS. The strain on acute NHS services is well understood, with NHS trusts in England reportedly facing a £2.3 billion deficit by the end of the financial year. It has been claimed that, of a proposed £1.8 billion health budget increase pledged in the autumn spending review for 2016/17, an eye-watering £1.6 billion is earmarked to ease financial and clinical pressure in NHS Trusts, according to figures from Cavendish Square.
Mental health has long been the poor relation in health provision and workers have ploughed on in difficult circumstances. With Cameron’s emotive talk of “revolution” – and invoking the scene from Les Miserables – I can’t help but envision the valiant soldiers of the French revolution; soldiering on in the face of overwhelming odds.
NHS England made it clear in its taskforce report what is needed to improve mental health services – and what many of us already know – that investing at the community and acute level impacts positively on the whole NHS system.
The preventative agenda for public health has long been seen as key to reducing demand on acute services. In spite of this, we are increasingly seeing preventative services being pulled as local authorities – who now hold responsibility for delivery of public health provision – feel the strain of cuts.
Without significant investment in community and mental health services, there is little opportunity of reducing the need for crisis care.
I would ask you to consider, based on past performance, can we trust the government? Not only to improve mental health provision but to protect the health service as a whole? It has been widely reported that the £8 billion promised for the NHS was sufficient to fund the “cash demand” needed to sustain the NHS. It seems that Cameron and the Treasury may have utilised a ‘politicking’ skill to present not so good news as brilliant news. According to Liberal Democrat MP David Laws, the amount actually needed to plug the NHS chasm is £30 billion – with £15 billion coming from efficiencies. At least, that is the figure that he claims NHS boss Simon Stevens reported as being required to prevent the NHS from going bust some 18 months ago.
Is it enough? In responding to the Mental Health Taskforce report, Health Secretary Jeremy Hunt acknowledged the huge burden mental health places on society; a staggering £105 billion each year. His assertion that the one in four people who experience mental health issues will “get the care they need, when they need it” and will prevent mental health problems from occurring at all, seems woefully ambitious given the numbers.
Let’s reflect on government spending on health compared to mental health. With a UK population for 2014 of 64.4 million and a total NHS spend for 2014/15 of £113 billion, this gives an annual health spend of £1,774.66 per capita. In comparison, a £11.7 billion spend on mental health services gives a paltry £4 per capita. Given that mental health costs the economy specifically and society generally £105 billion, a spend per capita of £4 is nonsensical.
Historically, there have been sustained cuts to mental health funding – certainly more so than other areas of health spend. Parity of esteem has been mooted for some time, and perhaps with the Prime Minister’s promise of increased funding, there is the will for mental health to cease being the poor relation. Sadly, it seems we are a long way off achieving this.
We know that people who experience mental health difficulties face barriers to accessing good quality healthcare. How then, can the government justify a double whammy for people experiencing mental health problems: inadequate provision to meet their mental health needs coupled with difficulty in accessing healthcare when they need it?
Given the numbers, it is difficult to see how the government will achieve the aspirations to improve the mental health and wellbeing of the population, and improve outcomes through access to high quality services.
Carol Bogg, health and wellbeing coach at Phoenix Coaching Solutions.