Government rejects bid to safeguard mental health spending in legislation

The Government has rejected a bid to safeguard mental health spending as a share of the total NHS budget in new draft legislation.

Former chief executive of NHS England Lord Stevens of Birmingham urged the Government to amend the Mental Health Bill to ensure there is no reduction in mental health spending as a share of the total health budget while the legislation is being implemented.

However, peers backed the Government and rejected his amendment by 112 votes to 19, majority 93.

Lord Stevens (pictured) said: “This amendment does not seek to tell the Government, or indeed the House of Commons, how much to spend on the NHS.

“All it says is that there should be a floor on the share of that total going to mental health for a time-limited period while this Act is being implemented.

“Government would continue of course to decide the size of the NHS pie. The Government of whichever complexion could decide to grow it, they could decide to shrink it, but the slice of that pie devoted to mental health would be protected for a time-limited period, not just at the local integrated care board level, but nationally.”

He noted that a ministerial statement last week “disclosed that the Government now intends to shrink the share of NHS funding on mental health services in the year ahead”, which he said sets a “negative new precedent”.

The independent crossbench peer said: “I think there are sadly real grounds for concern about whether the implementation of this Act will be properly and expeditiously resourced.”

However, health minister Baroness Merron said his amendment was “fundamentally flawed” and that primary legislation should not be used to tie the Government’s hands on spending.

She added that the amendment only applies to spending under the Mental Health Act and that the system “does not structure its accounts based on the legal framework under which a patient is held”.

Lady Merron added that spend on the Mental Health Act “should reduce over time and that is not undesirable”.

She said: “We all want to see more people cared for effectively in the community, so that the need for the use of the Act is reduced.

“This would require more investment in preventative community services, which surely is the preferable model to supporting severe mental illness

“In creating a legal requirement for the share of spend specifically under the Mental Health Act not to decrease, this amendment would actually preclude the shift from detention to prevention that I know we all want to see.”

Regarding the shrink in the share of NHS spending on mental health revealed last week, she said: “The portion of spend is almost exactly the same as it was last year, with a difference of just 0.07%.

“We do understand that concerns that the share of overall NHS funding for mental health will reduce slightly, however this does mean the mental health funding is being cut.”

She assured peers that spending on mental heath support is actually increasing in the next financial year.

The Government also rejected calls for an independent mental health commissioner with fears it would add “yet another body into an already cluttered” patient quality landscape.

The House of Lords voted against the proposal by 129 votes to 49, majority.

Tabling the amendment, Liberal Democrat peer Baroness Tyler of Enfield said: “I believe this role is essential in ensuring oversight and advocacy for people affected by the Mental Health Act.

“Unlike existing bodies, the commissioner would have a strategic cross-Government focus working to promote mental health, tackle inequalities, and be a powerful advocate for the rights and wellbeing of those living with mental health problems who would finally have a voice at the top table.”

Responding, Lady Merron said: “It is our position and remains to be so that by inserting yet another body into an already cluttered and fragmented patient quality and oversight landscape is seriously unlikely to provide the clear and strategic leadership or an effective voice for mental health patients as (Baroness Tyler) seeks, as we all do.”

She insisted that a mental health commissioner would “clearly overlap with existing responsibilities of other organisations”, most notably the Care Quality Commission (CQC)”.

The Government also saw off a bid to introduce an independent review process for patients with learning disabilities or autism placed in long-term segregation under the Mental Health Act 1983.

Peers rejected by 106 votes to 51, majority 55, an amendment to the Mental Health Bill tabled by Baroness Hollins, an emeritus professor in the psychiatry of learning disability at St George’s University of London.

Independent crossbencher Lady Hollins, who chaired a panel looking into long-term segregation and its impact on people with learning disabilities and autistic people, said: “Independent reviews have been found to be effective and I think they need to continue until long-term segregation ends.”

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