Philip Hammond will announce a £2bn real-terms increase in mental health funding on Monday as he unveils his first budget since Theresa May told the Conservative party conference that voters needed to know austerity was over.
The commitment should lead to comprehensive mental health support being available in every large A&E department. It suggests that mental health, long seen as a neglected area within the NHS, will benefit disproportionately from the annual health funding increase of up to £6bn a year announced by the prime minister in June.
In pre-budget interviews on Sunday, Hammond refused to comment on reports that better-than-expected tax returns have given him a £13bn windfall, reducing the need for the substantial tax increases that had been anticipated when May announced her spending spree for the NHS over the next five years.
But he also stressed that the measures being announced would be contingent on the government securing a Brexit deal with the EU – and that, in the event of there being no deal, he would have to return to parliament with an emergency budget setting out an alternative economic strategy for the UK.
In remarks with a different emphasis to May’s conference speech, he also played down suggestions that the budget would categorically mark the end of austerity, saying just that this might be the moment when people see “that the fruits of their hard work are now at last in sight” and that detailed decisions about more money for government departments would be made in the spending review next year.
On Sunday Hammond said that the most important spending decision in the budget was the extra cash for the NHS in England announced by May in the summer, with Scotland, Wales and Northern Ireland getting proportional extra sums in the usual way. The increase will begin in 2019-20, reaching an extra £20bn in real terms for NHS England by 2023-24. In one of the first indications of how that money will be allocated, MPs will be told that in England at least £2bn will go to mental health services by 2023-24.
Although sizeable compared to the £12bn a year currently spent on mental health services in England, the Institute for Public Policy Research (IPPR) thinktank said that the £2bn extra promised in the budget was only half what was needed to put spending more on a par with that of physical health.
In its 2012 Health and Social Care Act the coalition government legislated to create “parity of esteem” between mental and physical health, but there have been persistent complaints that this aspiration has never been achieved and May herself cited mental health as an area where services must be improved in the “burning injustices” speech she gave outside No 10 when she became prime minister.
According to a government briefing, the new money will ensure that mental health support is available 24/7 in every large A&E department – a key priority as people with mental health problems often turn to A&E because support is not available elsewhere.
The funding will also pay for more mental health ambulances, community services for people with mental health problems, specialist crisis teams linking schools, social services and young people’s mental health services, and teams in schools supporting people with mild and moderate mental health problems.
Harry Quilter-Pinner, an IPPR researcher, said that if the government really wanted to achieve “parity of esteem” between mental health and physical health, spending on mental health would have to rise by £4.1bn by 2023-24 to deliver treatment rates equivalent to those available for comparable physical health conditions. “To truly make progress towards parity of esteem the government will need to commit twice as much as they have today,” he said. “Without this the NHS will never be truly ‘free at the point of need’ for people experiencing mental ill-health.”
The Treasury has also announced that the budget will allocate £60m for spending on tree planting – but with most of that going on a £50m carbon credit programme that would fund an estimated £10m to be spent on trees over the next 30 years.
This will be Hammond’s third budget and, given the strong possibility of either a substantial reshuffle or a Tory leadership contest within the next 12 months, many MPs suspect it will be his last. It has been prepared amid reports that Hammond and May have clashed over whether or not it is responsible to increase spending and cut taxes with the deficit ongoing and Brexit likely to hit the public finances.
In his statement Hammond is also expected to announce:
* A cut in business rates for small retailers, as part of a £1.5bn package intended to boost the high street.
* Further details of plans for a new tax on tech giants – in an interview on Sunday Hammond signalled he could set a deadline for the UK to act unilaterally if he cannot secure action at an international level.
* Almost £1bn extra for adult social care.
* A £30bn transport network investment, with £28.8bn from vehicle excise duty ringfenced for spending on roads.
* Proposals to help struggling families access interest-free loans as an alternative to having to rely on loan sharks.
* A significant investment in superfast broadband.
* An increase in defence spending.
* An increase in spending on universal credit.
John McDonnell, the shadow chancellor, said on Sunday that Labour would appeal to other parties in the Commons to join it in voting down the budget if Hammond did not use it to announce a halt to the rollout of universal credit.
Commenting on the mental health announcement, Andy Bell, deputy chief executive of the Centre for Mental Health, said: “Increasing mental health spending as a proportion of NHS funding for the next five years is an important step towards parity. It is vital that this investment is earmarked for mental health to ensure it brings about the promised improvements in care and support and to put right the decades of underinvestment in mental health services throughout the NHS.”
But Labour said the government should be spending more money now, not making promises about the next five years.
“If this announcement is simply money that’s already been promised, it will do little to relieve the severe pressures on mental health services that have built up because of this Tory government’s relentless underfunding of the NHS,” said the shadow mental health minister, Barbara Keeley.
