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NHS Funding Bill

Part of the debate – in the House of Commons at 7:46 pm on 27th January 2020.

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Photo of Munira Wilson Munira Wilson Liberal Democrat Spokesperson (Transport), Liberal Democrat Spokesperson (Health and Social Care) 7:46 pm, 27th January 2020

I thank the hon. Member for his intervention, and I completely agree that we need more support for our children and young people, not only in schools but in universities for students who are suffering mental health crises.

On the workforce crisis, we know that there are more than 100,000 vacancies across NHS trusts in England. I met a nurse on the doorstep in my constituency during the election campaign who works at West Middlesex Hospital. She was in tears because of the strain that she and her colleagues are under in that hospital. Workforce is arguably the largest risk to the delivery and implementation of the NHS long-term plan, yet the funding in the Bill does not include education and training. Again, we heard assurances from the Secretary of State that money would be forthcoming for this, but it is not guaranteed. That leads me to wonder whether this is not a priority area, and whether it could be cut, should spending come under pressure in other areas.

The mental health workforce has experienced little growth over the past decade. Gaps are often filled with temporary staff, which is not only expensive but undermines continuity of care and relationships. A recent survey by the British Medical Association revealed that four in 10 mental health staff found their workload either unmanageable or mostly unmanageable. If we are to achieve the laudable mental health ambitions in the long-term plan, we need to see substantial investment in expanding the mental health workforce.

The crisis in NHS infrastructure is acute and growing. The budget in the Bill does not commit to addressing the need in capital spending, either in buildings or in technology. The NHS’s annual capital budget is now less than its entire £6.49 billion maintenance backlog, which is growing at 10% per annum. That means that leaky roofs, broken boilers, ligature points in mental health facilities and outdated technology cannot be repaired or updated. The Wessely review described the mental health estate as some of the worst the NHS has, which is impacting on the quality of care. The review showed how dilapidated buildings and poor facilities are hindering treatment and recovery for patients. Will the Government use the 2020 Budget to set out a major multi-year capital investment programme to modernise the mental health estate in particular?

The Bill is fine as far as it goes, but frankly it does not go very far. If we want to progress from the status quo and truly transform our NHS services, the real-terms increase needs to be around the 4% mark that many respected commentators have called for, and we need a more holistic approach across the whole departmental budget, not just in selected areas. We heard from Dr Whitford about the huge cuts in public health grants to local authorities, and my fear is that public health spending could be cut further, as it sits outside the protected budget on the face of the Bill. That would be a false economy that puts further pressure on NHS budgets. And of course, until a solution to the social care crisis is in sight, the NHS will continue to shoulder the costs of inadequate social care provision.

This Bill is an opportunity to put mental health services on an equal footing with physical health in order to deliver true parity of esteem. I hope the Government will provide more guarantees that mental health, and CAMHS in particular, will not be overlooked, and that guaranteed funding will get through to the frontline. Liberal Democrats will be supporting what is largely a symbolic gesture in the Bill—a political gimmick to write into law what the public were promised more than a year ago. Is this a Government who trust themselves so little that they have to legislate to keep their promises?