Parity for mental health services ‘difficult to achieve’ amid funding restrains, say MPs

21 Sep 16

Achieving ‘parity of esteem’ between mental and physical health will be very difficult to achieve due to pressures on the NHS budget, the Public Accounts Committee has said.

In a report published today, the committee said the government had a “laudable ambition” to improve mental health services, but was sceptical about whether this was affordable or achievable without compromising other areas.

The committee recognised that government has, for the first time, put in place standards around how long people should wait for mental health treatment and the care they should be able to access. However, there was a lack of clarity around how these pledges would be met financially.

Today’s Improving access to mental health services noted that although the government had committed an additional £1bn for mental health over the next five years, this was not ring-fenced and could therefore be raided by cash-strapped providers, under pressure to make savings.

One in four adults is diagnosed with a mental illness at some point in their lives, but only around a quarter of those estimated to need mental health services have access to them. As outlined by the committee, the challenge is to build joined-up services within the health service and across other parts of government that provide access to the services that people need across the country.

However, the PAC found that systems for working across government were weak. For example, there is no consistent way to access mental health services for people leaving prison. Also, school counselling was inconsistent across the country, and there was a disconnect between the NHS and the Department for Work and Pensions in helping people with mental health problems get back to work.

The way mental health services are designed was “complex, variable and difficult to navigate”, the committee added, with significant variation in peoples’ access to service. Providers and commissioners were also not sufficiently incentivised to deliver high-quality mental health services for all who need them.

Success in achieving parity would also hinge on the health service having the right staff with the right skills in place – but “there is not yet a clear plan to develop the workforce needed”, according to the report.

Among the recommendations included in its report, the committee called on both the Department of Health and NHS to collect and properly assess the data needed to improve services by the start of 2017-18. This was crucial to overcoming the challenge of placing mental health provision on a par with physical health.

Committee chair Meg Hillier said it was right the government was committed to giving mental health parity of esteem, since it was good for the individual and had wider benefits for the economy and society in general.

She said: “The government has committed to making much-needed improvements to mental health services, but we are concerned it does not yet have sound foundations to build on.”

She urged the DoH and NHS England to achieve a fuller understanding of the current landscape and the likely costs of achieving its goals.

“If these goals prove beyond the scope of the funds available then it is vital a plan is put in place to make best use of the money available.

“It is the responsibility of government to ensure its departments work together more effectively to support people with mental health conditions and in doing so reduce pressure on the public purse elsewhere,” she added.

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