Unanswered questions on “extra £1 billion” for mental health
23rd Feb 2016
An extra £1 billion will be invested on mental health spending by 2021.
NHS England says it has committed to spending this much extra on mental health services in 2020/21 from its existing budget, over and above what is spent at the moment. If this is the whole rise in mental health spending in England over the next five years, then the spending will rise more slowly than on other parts of the NHS. If it isn’t, then we’re no closer to knowing how much will be spent on mental health.
“New investment in mental health services… An extra £1 billion will be invested in mental health care by 2021”
Department of Health announcement, 15 February 2016
£1 billion extra to be spent on mental health care sounds impressive, but there’s a lot we don’t know about the figure.
If this is the whole rise in mental health spending in England over the next five years, then the spending will rise more slowly than on other parts of the NHS. If it isn’t, then we’re no closer to knowing how much will be spent on mental health.
The announcement is about where money that’s already committed to NHS England will go—it will be spent on mental health services rather than other parts of the NHS. It doesn’t mean any new money from the government.
What’s new is the commitment from NHS England that £1 billion will be invested in mental health services specifically. Even then, some of that had already been announced by the Prime Minister in January.
Putting £1 billion in context
NHS England told us the £1 billion is a cash terms rise for mental health services.
The overall NHS England budget is set to grow by about £19 billion by 2020/21 in cash terms, from £101 billion in 2015/16 to £120 billion.
The £1 billion announcement makes up 5.4% of the total rise.
Last year 11.9% of NHS England’s budget went to mental health. It spent £11.7 billion on mental health services in 2014/15 according to figures it reportedly released to social care website Community Care. That was out of a total budget of £98.1 billion.
That means that for mental health spending to grow at the same rate as the rest of the NHS, around 11.9% of the £19 billion extra that is given to NHS England needs to be spent on mental health. This works out at roughly £2.2 billion.
Most mental health spending is done by clinical commissioning groups, local bodies which receive money from NHS England and then purchase services from hospitals and other providers. There’s nothing to stop them diverting more of their money to mental health services, and so the total NHS spend may well go to £2.2 billion or over.
The fact is we don’t know yet—we don’t know the commissioners’ plans for this year, never mind in 2020/21. A panel of experts has recommended the commissioners should have to publish how much they spend on mental health from 2017/18 onwards.
We also don’t know how much will be spent on mental health services by other parts of the government. Currently over half of spending on mental health services comes from outside the NHS, notably from local authorities.
Overall, then, despite last week’s announcement it’s too early to know how much money will be available to mental health services in coming years.
The recommendations made by the mental health taskforce will be funded
The spending announcement follows recommendations given to NHS England by an independent taskforce. The taskforce thinks these will cost £1 billion.
Some of the money had already been announced.
In January the Prime Minister announced programmes which he said were worth £940 million over a period of five years.
NHS England has confirmed to us that this spending is included in the annual £1 billion. It gave us this statement:
“The mental health taskforce proposals need an extra £1 billion a year to be spent on new mental health services annually by 2020, and that’s precisely what we’re committing to today.
“Only the most bizarre mangling of that fact would claim this isn’t ‘new’ money when it patently is new funding for mental health over and above what is being spent today, and money that is for the first time being earmarked for mental health from future funding growth. On any definition this is genuinely new investment in mental health.”
So the recent announcement tells us there’ll be at least £1 billion extra for NHS mental health services, in five years’ time, on top of what’s spent today.
It doesn’t tell us what the total amount spent on NHS services will be, or what will happen to overall funding for mental health.