Wednesday 23 June 2010

More Budget Reflection

We won't know quite how bad the cuts to public expenditure in Wales will be until the autumn (and there might be some modest easing if the promised review of the Barnett formula acknowledges Wales' current disadvantaged position). In any event there will be severe cuts in the coming years and those of us seeking to protect and enhance mental health services need to get our tactics right. My guess is that the Assembly Government will attempt to protect the NHS budget but even an index rise really means cuts because of the insidious "NHS inflation" which means its costs rise more than everybody else's.

A reasonable campaigning position would be to aim to sustain real-terms, current NHS spending on mental health as a high priority compared to other health areas - not unreasonable since mental health is a declared priority of the Assembly Government. The Councils may take a greater hit and I predict a hard fight to protect mental health social care.

Meanwhile patients' groups like Hafal need to offer practical ideas for efficiency savings which can be used to improve services where standards are not yet being met: here's two for starters...

(1) Accelerate the repatriation of patients from expensive care providers whose approach is to overstaff and overcharge for untherapeutic services.

(2) Rationalise the proliferation of specialist community teams alongside a wholesale reorganisation and refocusing of the core Community Mental Health Teams (see this post).

It is interesting to see that the Royal College of Psychiatrists is moving towards the idea of CMHT rationalisation: I gave evidence to their Service Redesign Enquiry in February and this and other ideas feature in their report here published this week.