Our local mental health Trust Norfolk and Suffolk NHS Foundation Trust (NSFT) is facing £36 million of further central government cuts over the next two years. The Trust is already underfunded and has been put into ‘special measures’ because it’s struggling. So I fear the very practical consequences of the latest swathe of cuts on people who rely on the Trust’s services and staff who are already saying they are finding it hard to do their jobs properly.
Cuts to mental health have got nothing to do with the deficit
We need to be clear that this £36 million cut (and so many others) are not, as the Tories claim, the inevitable consequence of ‘having to bring down the deficit’. Put as bluntly as possible, our public services are being slashed so the Tories can reward their myriad supporters with tax cuts.
That claim is completely at odds with the Tory record in the last Parliament of cutting annual tax for corporations by £4bn and for the richest 1% of individuals by £3bn. And now they are going further – the £7bn of personal tax cuts promised by Tories in run-up to the General Election mean overwhelmingly handing over more yet more cash to the already rich.
Add in the fact that the amount of tax lost through non-payment and avoidance increased last year to £35bn, and it’s crystal clear that there is nothing ‘inevitable’ about this latest £36million cut to local mental health services and no need for it as part of ‘deficit reduction’.
These tax cuts and lost tax revenue – totaling around £50bn – add up to well over four times the annual amount we spend as a whole country on mental health services.
The painful reality of years of local mental health cuts
I first met mental health staff working at NSFT in back in November 2011 shortly after my selection as the Labour candidate for Norwich South.
What struck me was that people wanted to talk to me not so much about impact of cuts on their jobs but rather their fears for what this would mean for the people they supported. They also feared the cuts to wider social security budgets would fall disproportionately on those with mental health needs. They were right.
Under the last Tory-led Coalition government, NSFT itself was forced to cut around a 20% of its own budget over a four year period.
I listened with growing concern as staff raised first internally, then externally, their fears about the cuts. They told me of services fragmenting and caseloads becoming unmanageable. The new ‘front door’ to mental health services – the Access and Assessment Team was soon overwhelmed - funded for 50 referrals a day, yet getting between 100 and 140.
Supporting the fightback against mental health cuts
The Campaign to Defend Mental Health Services in Norfolk and Suffolk’ was launched in November 2013. Attending that first meeting I had to listen from the corridor as more than 300 people packed into the public meeting at the Vauxhall Centre in Norwich. Here I listened to staff, users of the service and family members as they spoke with passion, anger, fear, compassion and often through tears.
In April 2014 I walked the second day of the ‘Walk for Mental Health’ from Ipswich to Norwich to raise awareness of the continuing impact of cuts. There I heard first hand from Nicci, a nurse in a crisis team, about the reality of trying to find beds in the middle of the night, across the country for people in crisis, of community teams overwhelmed, of people falling through ever widening gaps. I heard from Jess about the drastic reduction in support available in the community, and from Beth about her fears that cuts in teams that she benefited from would mean people would not be supported in the same way that she had benefitted.
I heard how staff were continuing to ring alarm bells at every level; at meetings with NSFT management, with the Care Quality Commission and in face to face meetings with Norman Lamb the then Care Minister.
We need real change to the way we fund mental health services – locally and nationally
The truth is that the whole mental health system remains woefully underfunded. Nationally, mental health accounts for around 23% of health need, yet on average only attracts 10% of funding.
The mental health system is also unfairly funded – mMental health services continually lose out to acute physical health hospitals. NSFT are given a set amount of money each year, regardless of how many people need their service. In acute hospitals, the money follows the patient and the hospital is paid by ‘activity’, so if their referrals increase, so does the money they receive for providing care. As a result, NSFT is reportedly under funded by £30 million per year compared to acute hospitals.
Locally, the whole way that mental health services in our county are commissioned and funded needs to be reviewed. There are 5 different CCGs in Norfolk & Waveney, and the responsibility for mental health ‘rotates’ between them all annually. First was North Norfolk CCG and currently it’s South Norfolk CCG. This constant change does not make any sense to me, when it seem obvious that stability in the system is desperately needed.
Nationally, we need to take a step back and look at our mental health system as whole. We need long term, sustainable commissioning, not knee-jerk responses to gaps caused by the starvation of NHS services.
I will continue to fight for our local mental health services
I will be requesting a meeting with CCGs, and also be seeking a meeting with the improvement director at NSFT and the board of directors. I will be taking these problems up directly with the Health Minister and am also working on getting these issues debated in parliament.
If you use or have tried to use local mental health services please get in touch. Equally, if you are a member of staff living or working in Norwich South please get in touch, in confidence, if there is anything you want to let me know or think I can help with. You have my word this will continue to be an issue I will fight for.