NHS bosses have accused Boris Johnson of “structural discrimination” against mental health and ignoring the huge psychological damage being wreaked by the pandemic.
A decade of progress on mental illness has come to a halt under a prime minister who seems more interested in building “shiny new hospitals” than tackling the mounting toll of debilitating ill-health, they say.
The government is condemning the growing number of people struggling with conditions such as depression, anxiety and PTSD to “distress, pain and suffering on a huge scale”, it is claimed.
Saffron Cordery, the deputy chief executive of NHS providers, launched a scathing attack on Johnson’s apparent disinterest in mental health in an interview with the Observer. In it she warned that patients will have to wait longer for treatment, with some missing out on care altogether, unless ministers give mental health the same priority as physical illnesses such as cancer and diabetes.
NHS mental health services are already too stretched to deal with rising demand, especially with Covid-19 having led to what experts say is millions more needing help, and they are being unfairly treated by Johnson’s administration compared with the priority it is giving physical health, she said.
“The worry here is that the government has lost its focus on mental health at the very moment it’s needed most. We are seeing genuine structural discrimination, which is impacting on mental health services”, said Cordery, whose organisation represents England’s 54 specialist mental health trusts.
Johnson’s failure to invest in mental health has left services unprepared for the big increase in people needing care that rising unemployment and social isolation are bringing, she added.
The fact that only two of the 40 new hospitals Johnson recently announced will be mental health facilities was proof of the “structural discrimination”, she said. And she revealed that the original list of 40 projects was going to include eight providing mental health care, but six were dropped at the last moment, with Downing Street giving no explanation for the decision.
“It’s so disappointing that the organisations on the list of new hospitals [didn’t include] a significant number of mental health trusts. There were eight that should have been on there but six were left off. We don’t know what happened, but they were dropped.
“That signifies that the focus is more on providing those shiny new hospitals, the big acute services, rather than [investing in mental health]. There isn’t the same commitment behind investing in mental health facilities as there is behind investing in [acute] hospitals”, Cordery added.
However, NHS bosses and health experts believe the “40 new hospitals” pledge has been spun by Johnson and health secretary Matt Hancock and misrepresents the fact that many of the projects will be rebuilds or refurbishments, that the £3.7bn allocated is only a fraction of the likely £20bn outturn cost and that the 2030 deadline is unrealistic.
The “complete disparity” in the number of targets for access to mental health care compared with the array of waiting time standards in physical health, such as A&E care within four hours and routine surgery within 18 weeks, also underlines how those with psychological and psychiatric illnesses suffer from the “historic and deeply embedded” systematic discrimination against the sector.
“That is evidence of inequality and has produced a care deficit in mental health relative to physical health. In the NHS what’s measured is what matters, and there are more targets in acute care than physical health, which again shows it’s not as high a priority as it should be.” Although charities and NHS England mental health chief Claire Murdoch are working hard to improve care, ministers are responding with “rhetoric” and inaction.
While the Tory-Lib Dem coalition government took “huge strides forward” on the priority and funding given to mental health, including “parity of esteem” with physical health, progress which Theresa May continued, “the announcement of the 40 new hospitals does feel like a bit of a full stop. I am struck by the fact that none of Boris Johnson’s signature pledges on the NHS – 40 new hospitals, 50,000 more nurses and millions more GP appointments – involve mental health.”
Dr Adrian James, the president of the Royal College of Psychiatrists, echoed Cordery’s concerns. “Parity of esteem cannot be a term that is bandied around by politicians, it must be accompanied by action. We stand on the precipice of a mental health crisis. The government must do all it can to protect everyone from the mental health consequences of the pandemic.”
Conservative MP and ex-health minister Dr Dan Poulter, who is also a psychiatrist in the NHS, said urgent action was needed to tackle the archaic state of some mental health facilities.
“The condition of many inpatient psychiatric wards is well below the standards that we would expect in other parts of the health service. Sometimes as many as 10 patients have to share a single bathroom or toilet, and many mental health wards are in a poor state of physical repair. This is frankly unacceptable and needs to be urgently addressed, but a chronic lack of funding for mental health services has left many mental health providers without the funds to deal with the problem and invest in badly needed inpatient ward improvements”, he said.
The fact that acute hospitals were given extra money in the spring to send patients with physical ailments to be treated in private hospitals, but NHS mental health trusts were not, also illustrated the “structural discrimination”, Cordery added.
A Department of Health and Social Care spokesperson said: “We are absolutely committed to supporting everyone’s mental health. The prime minister announced in June £1.5bn for hospital maintenance, eradicating mental health dormitories and improving A&E capacity.
“This is on top of £10.2m to mental health charities to support adults and children affected by the pandemic