The claim
“The mental health budget has not been cut. It has actually gone up in real terms and we can show you the numbers.”
Jeremy Hunt, Channel 4 News, 24 March 2015
The background
Conservative health secretary, Jeremy Hunt, his Lib Dem colleague Norman Lamb and Labour shadow Andy Burnham had a bit of a ding-dong on Channel 4 News last week.
Both coalition ministers were keen to deny accusations from Mr Burnham that the coalition has presided over cuts to spending on mental health in this parliament:
With Liberal Democrat leader Nick Clegg promising today to spend an extra £3.5bn on mental health over the next parliament, it seems a good time to look at the coalition’s record on mental health – an area currently overseen by a Lib Dem minister.
The analysis
Mr Lamb has been asked about the mental health budget in parliament, and this is what he told MPs:
At first glance, this looks fairly straightforward.
We’ve crunched the numbers with the latest official GDP deflators to factor in inflation, and we reckon this adds up to a small real terms cut over five years: the budget was £11.71bn in 2009/10, £11.77bn in 2010/11 and £11.66bn in 2014/15.
We put this to NHS England and they told us things were far more complicated, thanks to NHS reforms which replaced Primary Care Trusts (PCTs) with Clinical Commissioning Groups (CCGs) in 2013.
They said the numbers quoted by Mr Lamb “compares spend by PCTs (this relates to years 2008/09 to 2011/12) with forecast spend by NHS England and CCGs (the figures for 2013/14 and 2014/15).
“The commissioning responsibilities for NHS England and CCGs are not the same as the commissioning responsibilities for PCTs. For example, some services that PCTs commissioned transferred to local authorities. Therefore you cannot compare the two sets of data directly…”
Mr Lamb didn’t mention any of this to parliament, but never mind.
The basic point here is that these figures don’t cover all spending on mental health. Some services are commissioned by councils, schools, the voluntary sector and so on.
This is a line NHS England have used before – most recently when presented with the results of an investigation by BBC News and the award-winning journalist Andy McNicoll from the online journal Community Care.
Using Freedom of Information requests and other research, McNicoll got data from 43 out of 56 mental health trusts in England and found there had been a real terms cut of 8 per cent in funding between 2010/11 and 2014/15, worth around £600m.
Again, the answer was that mental health services were available through other organisations. The research didn’t tell the whole story.
That’s undoubtedly true, although other figures suggest there have been cuts in other areas too.
For example, the latest stats from the Health and Social Care Information Centre show a clear reduction in spending by local councils on “adults with mental health needs”:
But hang on – NHS England said some services were transferred from PCTs to local authorities in 2013. So wouldn’t you expect the funding to go up after 2013?
And who pays for this transfer anyway? Do councils get more money from central government to cover these new services, or do they have to find the money from within their existing budgets (which sounds like a cut to us)?
We asked NHS England this question – and if there is a set of figures that does cover all the different spending streams over this parliament.
A spokesman said: “Comprehensive comparable data for years before NHSE was in existence is not available and we can’t comment on the council funding.
“We can show that spending on the services we offer for mental health (which is comparable last year and this year) has gone up.”
Mental health groups have long accused the government of a lack of candour in this area. In 2012 the government admitted that it had scrapped an annual survey of investment in mental health services.
The government’s spokesman in the House of Lords, Baroness Jolly, said this had been done to “reduce bureaucracy” but critics noted that the decision to bind the survey had been taken after it showed a fall in spending.
The verdict
All of this sounds formidably complicated, but actually the situation is fairly straightforward.
The government says it has not cut overall spending on mental health, and it says it can prove it (“we can show you the numbers”).
But when challenged, no numbers are forthcoming.
The numbers ministers have come up with in the past make it look very much like there has been a cut in real terms – as does all the other evidence we have seen.
The fact that we are having to piece together scraps of information is arguably the biggest problem here.
The coalition can’t or won’t tell us how much it has spent on mental health over this parliament – and ministers even scrapped one of the key measures after it showed there had been a cut.
This is very concerning, not only because it seems that less money is being spent on these vital services, but also because of the lack of transparency. Our elected representatives have a responsibility to be honest about how our money is being spent. If they feel cuts to mental health services are justifiable, they should explain why.
On the ground, in the service both primary and secondary there has been a cut. I’ve seen it myself. I’ve had staff from within mental health service express their struggles to meet demand for their service because of cuts to their funding. Waiting times to get help are months rather than weeks leaving patients at risk. Many patients are being discharged with unmet care needs and again, left at risk. I know of cases where those patients have gone on to self harm and in the worst case take their own life. There is not the parity of care this coalition promised.
I have a 51 year old daughter with mental health issues and there is absolutely no doubt support for people with mental health issues have been cut. In many areas such as care for adults with a learning difficulty the cuts have been dramatic, skilled well payed care workers are being replaced by unskilled awoke re. The attitude being , you don’t need skills to be a care worker, any Tom Dick of Harriet will do as long as they are cheap, resulting in the quality of life of these groups being destroyed, inch by inch one drip at a time. It beggars belief that Hunt can lie about funding, but then again he lies about all health or NHS issues. What really shocks me is to catch Norman Lamb lying through his teeth on this subject, I am heartily sick of five years of lies from the Coalition ministers
I know for certain budgets have been cut in my local area. We have seen Mental Health services being closed and clumped together, leading to a poorer service.
I used the service years ago and found I needed to use them again recently and the difference is shocking in relation to waiting times for assessment and getting treatment.
With suicide being one of the most likely ways for young men to die in this country it seems wrong this should be the norm.
What the Government have also sneaked in under the care reform act coming ito effect in April, is taking away protection from excessive charges for services, that a person can practically be able to pay, (clause s9 to s14 in the reform) which is something I’ve been stung with for daycare for my mentally disabled son.
I was reassessed in Jan which saw me being expected to pay nigh on £50 pw, and on seeing my MP who then wrote to my councils social services leader (Leed’s council) they are now taking legal advice over these new rules.
Norman Lamvb MP wrote a article in the Huffington Post regarding the new care act, and how wonderful it will be, I tried to contact him, but he’ s refused to answer.
Bottom. Line, once again under this Government, the most vulnerable are being attacked, whilst the tax evaders are tippy toed around, even they they lose the country billions, whilst carers save the country billions, which even Cameron acknowleged in PM question time. Don’t forget, multi millionaire Cameron claimed benefits for his son.
Whatever the exact figures, services in Sussex have been harder to access than in previous years, a lack of available staff often being an issue. As soon as someone comes into secondary services there is huge pressure to discharge them, sometimes prematurely. People with mental health issues are highly vulnerable, and we have seen suicide rates increase; an indicator of a failure by society, and financially constrained mental health services. This may reflect many factors of course, but a lack of access to the right initial support, therapy, clinicians, etc. is likely have had some serious affect. Ministers manipulating facts and refusing to provide data should be ashamed of themselves, and are not worthy of the office they hold.