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Mental Health: Funding

Volume 690: debated on Monday 12 March 2007

asked Her Majesty’s Government:

What resources have been withdrawn by primary care trusts from mental health services to offset the deficit in acute hospitals in this financial year.

My Lords, returning the NHS overall to net financial balance is a key priority for financial year 2006-07. We have not expected any one NHS sector, including mental health services, to contribute more in financial savings than any other part of the local health economy except where that sector has specifically contributed to an organisation’s deficit.

My Lords, I thank the Minister for that reply, but it is not entirely consistent with information made available to me by local services directly. This year, about £30 million is being transferred directly from mental health; next year, about £60 million will be. Does the Minister agree that that, at a time when mental health services are meant to be a priority, is not helpful to developing and modernising mental health services? Does he not also agree that if acute hospitals balance their budgets by raiding easy targets such as education, mental health and services for older people, it militates against developing a sound and responsible financial regime in NHS acute hospitals? Is this just NHS business as usual?

No, my Lords; it is the NHS sorting out its finances and making sure that the deficit is cleared by the end of the financial year.

My department has looked into six cases where it has been alleged that reductions have been unduly imposed on mental health services compared with other parts of the local health economy, but our investigation did not find that to be the case. If there are other instances, I would be very glad to look into them. I remind the noble Baroness that in 2001-02 to 2005-06 there was a 25 per cent real-terms increase in resources for mental health services. I accept that there is more to do but there has been a big increase in investment.

My Lords, where will trusts place those who are most vulnerable when mental health hospitals are closed down due to cost-cutting exercises, especially as, with an ageing population, there is widely predicted to be an increase in the number of Alzheimer’s sufferers?

My Lords, the health service clearly has to take tough decisions this year to ensure that it gets back into balance, and I am sure that that is the right approach. Local primary care trusts have to make difficult decisions and ensure that the decisions they make will have the least effect possible on the kind of people whom the noble Baroness mentioned, who need the services. As I said, we do not have evidence that mental health services have been unduly affected. Indeed, we have seen a big expansion in those services in the past few years.

My Lords, what observations does the Minister have on reports this weekend about the war veterans from Afghanistan and Iraq—I think the quotation was more than 20,000 of them—who were suffering from various mental health illnesses and were having to wait up to four years for treatment?

My Lords, my right honourable friend the Secretary of State for Defence commented on this matter this morning. The case that was mentioned over the weekend is being investigated. Officials from my department and the Ministry of Defence have worked together to improve the provision of psychological therapies for war veterans. We are committed to improving mental health services generally. We shall continue those discussions.

My Lords, given that this year primary care trusts such as that in Hillingdon have announced cuts of £1 million from April 2007 to community mental health services provided by the voluntary sector—Rethink, Mind and Alzheimer’s groups—does the Minister anticipate that the level of community services will drop next year? Is his department making any provision for increased acute services as a result?

My Lords, I shall not comment specifically on Hillingdon because that is not appropriate. These are matters for the local health service to decide. It is clear that a large amount of the deficit in the NHS is caused by a small number of organisations. We cannot run away from the fact that those organisations have to turn that situation around. Of course, we shall wish to see patient services protected in any moves they make, but in the end they must bring those organisations back into a balance.

My Lords, will my noble friend confirm or deny that the £4 million national young people’s substance misuse partnership grant, which hitherto has been ring-fenced specifically for preventive work with youths with drug, personality and mental problems, is being diverted to offset deficiencies elsewhere in the NHS?

My Lords, I can neither confirm nor deny the specific point that my noble friend raises but I shall certainly investigate it. Part of the strategy adopted by strategic health authorities in particular is to look at ways in which contingencies can be raised through the central budgets they are responsible for. We very much see this as an initiative that has to be taken this year to get the health service back in balance. I assure my noble friend that I shall look into the specifics of the case that he raised.

My Lords, if the Government have ring-fenced an amount for a particular service, as the noble Lord, Lord Brooke, said, surely that has to be maintained. For the requirements and specialties to be affected at this stage means that there was no point ring-fencing them in the first place.

My Lords, if a sum has been ring-fenced, clearly that money should be spent on the service for which it has been ring-fenced. I have undertaken to investigate this matter. As I said to my noble friend, part of the strategy of strategic health authorities is to use non-ring-fenced central budgetary programmes to create a contingency fund. I shall certainly look into the specifics of that case and write to my noble friend.

My Lords, as part of their financial balancing exercise, are the Government looking at the cost incurred due to delayed or unobtained treatments and the cost incurred by other parts of society when health service funding is cut?

My Lords, we should recognise that in the past few years the NHS has seen a huge increase in resources—the largest increase it has ever had—which has resulted in hugely enhanced services and a drastic reduction in waiting times. Of course, it is important that the health service gets back into balance—it will do so by the end of the year—but that has to be seen in the context of a hugely expanding health service which, since 1997, has seen the number of staff employed rise from 1 million to 1.3 million. We should applaud that.