NHS shakeup tackles disparity between mental and physical health services

Mental health patients must have 'parity of esteem' in doctor's surgeries, insists health minister Norman Lamb
Norman Lamb, health minister
NHS shakeup – Norman Lamb, the health minister, is 'concerned' that mental health spending has fallen in real terms for the first time in a decade. Photograph: PA

NHS patients should wait no longer for mental health therapies than they do for treatments for their physical conditions, the government will announce.

With more than 6 million people suffering from depression or crippling anxiety but only 75% receiving any medical help, the government is to propose that NHS mental health patients have a "parity of esteem" in doctors' surgeries.

The policy will be formally announced on Tuesday as part of the mandate for the NHS commissioning board, the means by which the health service will be held accountable to parliament under its reforms. The "contract with the NHS" will specify that mental healthcare should be on a par with physical care – "that it values mental and physical health equally".

As a first step, patients will be able to ask to be seen by a doctor as quickly as those with physical ailments, under the so-called 18-week waiting-time target. The London School of Economics reported in June that the depressed waited more than six months, while median waiting times for physical treatment were less than three weeks.

The mandate will say that mental health patients must get a personal care plan that addresses "the imbalance between the general health of those with mental health problems and the wider population".

The move marks a victory for the Liberal Democrats, with the party leader, Nick Clegg, and the health minister, Norman Lamb, pushing to ensure mental health is a priority in the coalition.

The Lib Dems have been increasingly concerned that the Labour leader, Ed Miliband, has stolen the party's thunder with a well-received speech on mental health last month.

Lamb told the Guardian he was "concerned" that mental health spending had fallen in real terms for the first time in a decade. In August the Department of Health revealed that investment in mental health for working-age adults dropped by 1%, once inflation is taken into account, to £6.63bn.

Lamb said spending was a long-term issue for the NHS and that it was previous Labour administrations that had prioritised physical over mental health. He pointed out that mental illness caused 23% of the total burden of illness, but accounted for only 13% of NHS spending. "This is the real problem … we need to ensure that patients get to see their doctor and be able to get access to the treatments they need. You cannot spend money unless you see patients," he said.

Before the election, Lamb had proposed a radical idea of mental health entitlements: if patients were not "treated on time the health board would pay for your treatment privately, if you so wished". However, coalition politics means he cannot go that far.

The government, he said, was committed to undoing the previous government's policies. Under Labour, Lamb said, the NHS bought treatments for patients with physical illnesses for a fixed price, the so-called national tariff, which was set higher than its costs, whereas for people with mental illnesses they had to find the cheapest therapies.

"The tariff sucked spending through the system for physical illness … we need to see how to put that right," said Lamb. "Mental health has been excluded from major health policies, such as waiting-times standards, and people have suffered as a consequence. I am determined to end this institutional bias that exists in the health service."

Lamb was keen to say that he was "not setting a specific waiting-time target, but we are saying to the NHS for the first time: let's start collecting the data so we can understand the scale of the problem, address unacceptable delays and then move towards establishing proper standards to significantly improve access and waiting times for all mental health services.

"We will be asking the NHS to demonstrate real and meaningful progress towards achieving true 'parity of esteem' between mental health and physical care by March 2015."

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