By Andy Bell
This week the Government published its ‘plan for health and social care’ in England. The much-awaited document set out plans to increase National Insurance payments in order to increase funding for both the NHS and for social services. For mental health and social care services, however, and for people living with mental health difficulties, the plan offers little clarity about the future.
The additional funding announced for the NHS, for example, is identified to reduce the backlog of elective acute care. Unlike previous health care spending announcements, there is no mention of additional funding for mental health support, despite a recognition that demand for mental health services is rising and is projected to increase further as a result of the pandemic. It is vital that mental health support is not sidelined by the need to address growing waiting lists for physical health care. And it will be crucial that the whole of the health and care workforce gets support for its mental health, too, in the aftermath of the traumatic events many people have experienced (and continue to go through today).
the payment system for social care means that many people with mental health needs have to pay for some or all of their care, facing complex bureaucratic procedures to get access to basic services
On social care, the plan offers scant detail, especially for people of working age. While the focus of the document is on the thresholds for charging and co-payment, decisions about how social care will be structured and placed on a more sustainable footing will be made in a future white paper. Mental health social care is an essential service, yet it has struggled to maintain its statutory responsibilities under the Care Act. And the payment system for social care means that many people with mental health needs have to pay for some or all of their care, facing complex bureaucratic procedures to get access to basic services.
On public health, the plan remains mostly silent. Local authorities have faced years of austerity and funding cuts for both social care and public health services, and there is little assurance about whether they will be reversed in the next few years. The paper does discuss prevention, but the focus is on the role of the NHS in offering health checks and giving people advice about their individual ‘lifestyles’ and ‘behaviours’. This offers little to the public’s mental health, and without a recognition of what determines our chances of good or poor health, it risks being a missed opportunity to put prevention at the heart of the reformed system. With MPs set to vote on reducing Universal Credit payments by £20 a week later today, many thousands of people may face greater risks to their mental health within weeks. We urgently need to focus policymaking on actions that can promote better mental health for all, and reduce the inequalities that drive so much mental – and, subsequently, physical – ill health.
Without a strategy to protect and promote the nation’s health and wellbeing, the reforms announced yesterday will leave the NHS and local councils on the back foot, trying to meet ever-growing demand for support
The Government’s plan for health and social care will bring more funding into the NHS and (eventually) social services, and this will be vital. And while we await further decisions about social care, there remains an important opportunity to modernise a system which has been overlooked and undervalued since 1948. But without a strategy to protect and promote the nation’s health and wellbeing, the reforms announced yesterday will leave the NHS and local councils on the back foot, trying to meet ever-growing demand for support.
Watch Marsha McAdam and Kevin James share their own experiences of accessing social care for their mental and physical health needs:
