GK Strategy hosted a policy insights event on the future of mental health in the UK, hosted by former Care Minister and GK Adviser, Phil Hope, with Sir Norman Lamb, Chair of the South London and Maudsley NHS Foundation Trust and former Health Minister during the Coalition Government. 

In a watershed year for mental health policy, the discussion was wide-ranging and covered everything from the review of the Mental Health Act to the spending power of local authorities. Key issues to note from the discussion include:

1. There is not yet parity of esteem between mental health and physical health services

While funding commitments in mental health have increased in recent years, it still does not receive the ‘parity of esteem’ that so many have been calling for and that the Government hopes to achieve.

Sir Norman Lamb was quick to highlight that waiting lists are still ‘shockingly high’, particularly for young people who can sometimes see waits of a year before receiving treatment. Moreover, facilities need upgrading and there are still systemic barriers to the way mental health is perceived which prevent reaching parity. The review of the Mental Health Act is one area this could be addressed, as current proposals are a step in the right direction.

2. Workforce and skills shortages in mental health may prevent progress

Phil Hope highlighted that workforce and skills is ‘still a massive issue’, and Sir Norman Lamb recognised that quality recruitment in the independent and third sectors can be very difficult. Reform to the immigration points system was recognised as a route to improving international recruitment.

The need for investment in training was also highlighted as a necessity for upskilling staff. Recent investment announced by the government for training and expanding mental health teams in schools, to support children and young people, was welcomed.

3. The shift from competition to collaboration poses both a threat and an opportunity

Due to the UK’s departure from the European Union, European procurement rules no longer apply to the UK. These rules required a robust, competitive process but the UK’s departure aligns with a move to collaboration rather than competition. Sir Norman Lamb expressed some concern that this lack of competitive process may lead to reduction in quality, as providers become less driven by the standards of their competitors. Both Sir Norman Lamb and Phil Hope agreed therefore that there needed to be other means of holding the system accountable.

Sir Norman Lamb highlighted the importance of provider collaboratives, as well as the new statutory setup of Integrated Care Systems (ICSs). Both speakers shared concerns that local boards held no decision-making powers and became simply ‘talking shops’. Sir Norman Lamb expressed his concern that the proposals for ICSs did not require the presence of a mental health voice at the table – this was optional as per the decisions of each board.

4. The importance of capital investment and Treasury requirements

Both Phil Hope and Sir Norman Lamb recognised a ‘huge need’ for capital investment in learning disability and mental health facilities. Sir Norman Lamb stated that the quality of some facilities ‘is currently unconscionable’. There was recognition that capital funding limits (known as CDEL) imposed by the Treasury have led to massive constraints in this area.

It was suggested that this may open the door for public-private partnerships, because the private sector can make the investments for capital. It was suggested that controls in the NHS White Paper on capital expenditure decisions would be ‘a retrograde step’.

5. The case for social care reform continues to mount

It was noted that reform of social care has been a talking point for a long time, but whether it will come soon neither Sir Norman Lamb nor Phil Hope could predict. Sir Norman Lamb recognised that the UK does not ‘spend enough as a society’ on social care, and that the ‘consequences are there for all to see’. Sir Norman Lamb said that he personally prefers a social insurance model for social care funding that protects younger working adults. The role of local authorities in mental health care was also discussed, and Sir Norman Lamb highlighted that new funding for mental health services cannot simply recategorize funding from other budgets, such as those for local authorities.

A recording of the event is available to view if you were unable to join us or would like to revisit

To discuss these issues further or if you have any questions related to mental health and social care policy, please do get in touch via ian@gkstrategy.com and we would be delighted to setup a call with you.