NHS boss Simon Stevens recently warned that without additional money, plans to improve cancer and mental health treatment were in danger. So it felt like there might be cause to celebrate when the Chancellor Philip Hammond announced £10bn capital spending for the NHS in addition to £2.8bn extra for NHS England.
But look a little more closely and it’s the same old problem: another Budget, another disappointment for mental health and for the NHS. As Sir Malcolm Grant, chairman of NHS England, said this extra money will only go “some way towards filling the widely-accepted funding gap”. and suggested that hard choices will have to be made when the NHS England board meets next Thursday. Similarly, Sir Bruce Keogh, national medical director for NHS England tweeted: “Budget plugs some, but def not all, of NHS funding gap.”
There is little to suggest that mental health will get its fair share of the “exceptional” cash injection into the NHS announced by the Chancellor.
The £10bn for capital spending is the Government delivering on commitments made in the Naylor Review published earlier this year. £2.6bn of that £10bn is to support STP delivery – and only two of the twelve to benefit from the announcement today are mental health trusts.
The Treasury briefing is clear that the £2.8m of additional funding is for ‘day to day spending, for example surgeries and treatment.’ The emphasis is firmly placed on addressing missed targets on A&E and the referral to treatment. Without any mention of mental health targets, there is no assurance that any of this money is intended to improve referrals to mental health treatment.
That flies in the face of the Prime Minister’s commitment to end the ‘burning injustice’ of mental health and flies in the face of patients who are left languishing on waiting lists with no sign that help is any nearer.
If you’re attending A&E with a mental health problem, you are very unwell. We know that we can stop patients reaching crisis point and improve their chances of recovery if community services intervene early enough. Focusing on A&E means the system continues to be geared towards crisis rather than early intervention against most clinical evidence.
Last year the Chancellor failed to give mental health any mention in the Budget he delivered to Parliament.
This year, he referred to it once in his speech, and it was also mentioned in the Red Book document published by the Treasury afterwards.
First when £28m was announced for Kensington & Chelsea council to fund mental health services, regeneration and a community space following the Grenfell Tower disaster. This will be of huge benefit to those dealing with the psychological scars of such a traumatic event.
Second when the Government reaffirmed its commitment to publish a Green Paper on Child and Adolescent Mental Health in December and to deliver parity of esteem. The Green Paper was originally announced in January, meaning we have been waiting for nearly 11 months for its publication.
This is now a matter of urgency. As the case of girl X, highlighted by Sir James Munby over the summer, showed there are shocking gaps in provision within child and adolescent mental health services.
The Chancellor has batted the ball back into NHS England’s court. He’s delivered less than half the money they asked for – they must now deliver the service.
Chancellor Philip Hammond’s announcement of extra funding for the NHS is better than nothing, but we urgently need the Government and NHS England to confirm that they will keep existing plans for the delivery of mental health promises on track.
It would be a catastrophic betrayal of people with mental illness if pledges already made to fund additional services were abandoned now.
We hoped that the Budget would give us the reassurance we needed that the bold ambitions of the Five Year Forward View were secure. In reality, that has not materialised. We urge the government and NHS England to make an unambiguous recommitment now.