Ministers risk ‘screwing’ mental health, warns Stevens

Lord Simon Stevens said ministers must ensure the standard is maintained in NHS rules for 2025-26, or else “mental health services would get screwed at a time when other things are prioritised”.

The MHIS requires all integrated care systems to increase their spend on mental health services by at least as much as their overall allocations — meaning its share of the total has gradually grown. ICSs are required to confirm to NHS England whether they have met the standard.

HSJ understands whether or not the rule will be maintained for 2025-26 is still being negotiated and discussed with the government.

Lord Stevens told the House of Lords on Monday it may also be necessary to ”recommend a strengthening of that mental health investment standard in the statute because it is inconceivable that the good measures laid out in the [Mental Health Bill] can actually be implemented while mental health services are squeezed as a share of the growing NHS budget.”

An HSJ leader article this month said “Mental health is not a priority for this government” and set out how ministers had not made a range of important decisions about the sector; including not confirming the future of the MHIS. 

The government’s bill currently before Parliament to reform the 1983 Mental Health Act was introduced earlier this month, following many delays under previous governments. The bill is intended to end the inappropriate detention of people with a learning disability and autistic people, give patients a greater say in decisions over their care and end racial discrimination in MH services. But Lord Stevens pointed out it would need funding and service expansion to work.

He said: “At a time when, understandably, there will be a great political focus on waiting times for physical health and routine operations, the most likely outcome, absent that mental health investment standard, would be that mental health services would get screwed at a time when other things are prioritised…

“The question is not just the content of the law but how it is implemented, how fast and in what context. We need to keep our eyes on all those as the bill proceeds.” 

Spending commitments made in the 2019 long-term plan for mental health came to an end earlier this year, and there remains a further lack of clarity on how mental health services will be funded by the new government. There was limited detail about other pledges for mental health in Labour’s manifesto.

The MHIS has been important in driving more spending into mental health services in recent years, and they have often been eroded in the past. The Health and Care Act 2022 requires NHSE and government to set out publicly whether the MHIS is being met, under an amendment introduced by Lord Stevens.

A Department of Health and Social Care spokesperson said: “We have been clear we will give mental health the same attention and focus as physical health.

“While funding for reforms and improvements to mental health services will be decided and announced in due course, the Budget provided an extra £26 million to open new mental health crisis centres and funding to provide talking therapies to an extra 380,000 patients.

“We are committed to recruiting an additional 8,500 mental health workers, providing access to a specialist mental health professional in every school in England and Young Futures hubs in every community.”

*amended on 28/11 at 10:30am to reflect DHSC’s comment