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Funding Settlement for the health service in England

Part of NHS Funding Bill – in the House of Commons at 3:00 pm on 4th February 2020.

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Photo of Jeremy Hunt Jeremy Hunt Chair, Health and Social Care Committee, Chair, Health and Social Care Committee 3:00 pm, 4th February 2020

I am well aware of the fantastic work done by Combat Stress, and I think it is important for it to receive the funds that it needs. However, when we look at the root cause of the problems in mental health funding, we see that on both sides of the Committee there is some culpability, and that on both sides it was completely unintentional. I hope that the shadow Secretary of State, Jonathan Ashworth, will forgive me if I start with the other side.

The truth is that when targets were introduced in the 2000s for A&E and elective care waiting times they were hugely effective, but they were introduced only for physical healthcare. As a result, during the austerity period when the budgets of clinical commissioning groups or primary care trusts were under pressure, money was sucked out of community and mental health services. That is at the heart of the problem that has bedevilled mental health care. The position changed in 2012, because a Labour amendment to the Bill that became the Health and Social Care Act 2012 instituted parity of esteem between mental and physical health. We were the first country in the world to do that.

As a Conservative, I am always deeply sceptical about legislating for principles, because I am not totally convinced that it ever changes anything, but that amendment did bring about a significant and very practical change, which I discovered myself as Health Secretary. No Health Secretary and no NHS chief executive ever wants to have to say publicly that the proportion of funding going to mental health has fallen on his or her watch, because that would be a direct contradiction of the principle of parity of esteem. That is why, since this became law, we have seen the proportion of funding of the entire NHS budget going into mental health either stabilised or starting to go up. That should put to rest some of the Opposition’s concerns about the risk of a decreasing proportion of NHS funding going into mental health, but it does not solve the problem.

The issue when it comes to mental health services for our constituencies is not about political will or funding; it is about capacity. We have an enormous number of ambitious plans on mental health. I unveiled one—in 2016, from memory—that said we would treat 1 million more people by 2020 and increase spending by several billion pounds. The mental health “Forward View” had some very ambitious plans, and we had the children and young people’s Green Paper. There are also targets to increase access to talking therapies, which are essential for people with anxiety and depression. But if we do not increase the capacity of the system to deliver these services, in the end we will miss the targets. For example, the children and young people’s Green Paper is an incredibly important programme, with a plan for every secondary school in the country to have a mental health lead among the teaching staff who would have some of the basic training that a GP would have to spot a mild mental health illness, anxiety or depression, or a severe one such as OCD or bipolar, and therefore know to refer it—[Interruption.] I am getting a look. I understand, and I will draw my comments to a close—