Prime Minister's Questions, factchecked

19 October 2016

Fewer police cells are being used to hold people with mental health problems

“The number of people who are having to be taken to a police cell as a place of safety... overall I think it’s more than halved, in some areas it’s come down even more than that.”

Theresa May, 19 October 2016

This is correct. The use of police cells as a place of safety under mental health legislation more than halved in the last year, from 4,357 in 2014/15 to 2,100 in 2015/16.

The Mental Health Act 1983 allows the police to detain certain people in ‘places of safety’ if they show signs of mental health problems and are in immediate need of care or control. There’s been controversy over the extensive use of police cells for this—as opposed to hospitals—in recent years.

The fall in the last year continues a falling trend over the last five years. Back in 2011 more than a third of all detentions were to a police cell, as opposed to a medical facility. Now 8% are sent to a police cell.

Not all areas follow the trend. In Avon and Somerset, for example, the use of police cells has risen, as has the total number of detentions under the Act.

Few pupils are both at grammar schools and on free school meals

“Just one in every thousand pupils is a child on free school meals in a grammar school”.

Lucy Powell MP, 19 October 2016

It’s worth studying this claim carefully. Ms Powell isn’t saying that only one in every 1,000 grammar school pupils is on free school meals. She’s saying that for every pupil who’s both on free school meals and in a grammar school, there are 999 who aren’t.

That’s correct.

There are around 3.2 million children at state secondary schools in England as of January 2016, according to official statistics.

Around 170,000or 50 in every 1,000—is a grammar school pupil. The government says that 2.5% of these children are entitled to free school meals.

That’s around 4,000 children out of 3.2 million, or 0.001%.

The government says that it wants to look also at “the wider impact of selective education of those on low incomes or who just about manage”—not just the very poorest children. So it’s not only interested in students entitled to free school meals.

We’ve covered the evidence on grammar schools and free school meals pupils in more detail here.

Total spending on mental health

“We are actually investing more in mental health services, an estimated record £11.7 billion”

Theresa May, 19 October 2016

It’s not possible to give an exact figure for government spending on mental health, according to the House of Commons Library. Theresa May has quoted the latest estimate correctly, but it should be treated with caution.

Mental health services are paid for by a wide range of different organisation. When NHS England asked them to estimate how much they planned to spend on mental health services last year, the answer was £11.7 billion.

But we don’t know how much of that £11.7 billion was actually spent on mental health. There have been discrepancies in the past between planned spending on mental health and what actually happened.

We may know the answer in the future. This year, Clinical Commissioning Groups are moving to open-book accounting. They’ll be able to show where the planned spending actually went.

Is £11.7 billion a record figure? Since the estimates are fairly uncertain, we’re not sure how accurate or meaningful this is. We’re looking into it.

40% of mental health trusts have seen their incomes fall

“Analysis by the King’s Fund suggests that 40% of our mental health trusts had their budgets cut last year”

Jeremy Corbyn, 19 October 2016

Budget reductions for 40% of mental health trusts were reported by the King’s Fund, a health think tank, on 14 October.

It looked at the annual accounts of all 58 mental health trusts in England, which deliver around 80% of mental health care.

“40% of trusts have in fact seen reductions to their income” in 2015/16, according to that analysis, which is in line with other research from the past year.

NHS leaders are keen to stress that the money spent on mental health trusts doesn’t cover all spending on mental health. Some mental health services are provided by other organisations.

They also point out that almost 90% of Clinical Commissioning Groups said they planned to increase their spending. These are the organisations that actually purchase the majority of mental health services.

The King’s Fund has responded that “mental health trusts provide a large proportion [about 80%] of mental health care” and that there’s “little evidence that demand for these services has fallen”. So it “seems likely” that many CCGs are spending less than planned on mental health.

If money supposedly going into mental health care isn’t all showing up on the books of the people who provide it, some of it must be being spent on something else. One of the possible candidates is “deficits among NHS providers”.

NHS trusts in deficit

“NHS Trusts are in a financial crisis. According to NHS Providers, it seems to be the worst financial crisis in NHS history. 80% of acute hospitals now in deficit. There was a time in 2010, when the NHS was in surplus. What happened?”

Jeremy Corbyn, 19 October 2016

The latest figures show that 75% of acute trusts (hospitals) are in deficit.

In 2014 the regulator reported that 80% of acute trusts were in deficit. We’ve asked NHS Providers exactly where their figure comes from.

Acute trusts are only one type of NHS provider. Overall, 153 of the 238 providers of NHS services were in deficit at the end of June 2016. Two thirds of them were acute trusts.

Only 8% of NHS providers were in deficit back in 2009/10, according to the King’s Fund think tank. Since then increasing numbers of trusts have ended each year in deficit. The problem varies by sector though: mental health, specialist and community trusts have been in surplus over the past three years.

NHS Providers is a membership group for organisations that supply NHS services, like your local hospital. It has said that trusts are reporting “the largest deficit in NHS history”. Experts at the King’s Fund agree.

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