The NHS is one of our most prized institutions. As former Chancellor, Nigel Lawson, put it: “it is the closest thing the English people have to a religion.” Understanding why it is so popular is not difficult. The NHS is there for us in our moments of greatest joy and of deepest grief, a place where our babies are born, and our elderly relatives go to die.
In the UK, we like to celebrate the fact the NHS is ‘free at the point of need’: anyone can access it regardless of their financial means. Illness may bring with it physical and emotional distress, but it shouldn’t result in financial distress. We are right to celebrate this. Across the globe, 400 million people still don’t have access to essential healthcare services. Thanks to the NHS, no one in the UK faces this injustice.
But before we get too carried away we must recognise that in many ways the NHS remains incomplete. The truth is that it is not ‘free at the point of need’ for everyone. Because all too often people suffering from mental ill-health do not receive the treatment they need, when they need it most. In fact, a staggering 65 percent of children and 75 percent of adults with a mental health condition will go without treatment even if the NHS meets the governments targets.
Imagine for a second that this was cancer not mental ill-health. Up to three-quarters of people going without treatment. Children turned away with the diagnosis: “your cancer isn’t serious enough yet, come back if it gets worse’. People required to fund treatment themselves or go without. This would be a national scandal. There would be public outrage. And, rightly so. Yet, on mental health we continue to tolerate the intolerable.
In one of her first speeches as prime minister, Theresa May signalled that she planned to change this. She committed to ‘fighting the burning injustice of mental illness’ and to delivering ‘true parity between physical and mental health’. And, in yesterdays budget, this commitment was given a boost, with the Chancellor announcing plans to increase spending on mental health treatment in the NHS by £2bn per year by 2023/24 as part of the budget.
This is undoubtedly welcome news. But the truth is it is nowhere near enough to achieve genuine ‘parity of esteem’.
Ensuring that people experiencing mental ill-health get equal access to high quality care and support when it is needed most is not going to be cheap. New analysis from IPPR, the UK’s progressive think tank, shows that to achieve this the government would need to double the commitment they made yesterday. That would mean NHS spending on mental ill-health rising from £12bn today to £16.1bn by 2023/4 – and then increasing further to £23.9bn by the end of the decade.
This is expensive but it’s also worthwhile. Mental ill-health affects so many people: one in four of us every year. For those with the most severe forms of mental illness - such as psychosis, bipolar disorder and personality disorder - it dramatically shortens life, by 15-20 years on average. Meanwhile, it costs our economy about £100 billion every year. That’s almost the same amount as we spend on the entire NHS. Whichever way you look at – morally or economically - this is an investment worth making.
In the coming months, the NHS will publish its Long-Term Plan, which will set out how the extra money - some £20bn per year by 2023/4, announced by the prime minister earlier this year – will be spent. It is crucial that this plan goes further than the £2bn announced for mental health at the budget today. Only by committing to real ‘parity of esteem’, and backing this up with the resources needed to achieve it, will we really complete the NHS. Only then can we claim that it is truly ‘free at the point of need’.
Harry Quilter-Pinner is a Senior Research Fellow at IPPR, the UK’s progressive think tank and co-author of Fair funding for mental health: putting parity into practise.