Mental Health Matters: What shadow ministers promised in Liverpool

Deep reform and pledges to fix a broken NHS were the theme of Labour’s party conference in Liverpool — but while headline policies to bring down elective waiting lists received a £1.6bn boost, party pledges for mental health were light on detail.

Brought to you fresh from attending the event, this edition of Mental Health Matters breaks down what shadow ministers are promising for the sector and gives a glimpse of what mental health services could look like under a Labour government.

Labour’s headline policies for mental health at this conference, repeated various times by shadow health secretary Wes Streeting at fringe events and during his keynote speech, were to provide mental health support in every school, and to create community mental health hubs in every neighbourhood.

While the latter fits with wider Labour health policy to shift from hospital-based care to a community-based model focused on prevention, school support is already pledged by the current government, though targets for scaling up remain conservative with 50 per cent coverage pledged by 2025.

Money for the proposed improvements will be unlocked by abolishing tax breaks for private schools, Mr Streeting said. The two policies Labour was pushing the hardest were not new — they were announced as part of a £1bn package at the 2021 conference, alongside commitments to recruit 8,500 new staff which the party said would help one million extra people access mental health treatment.

Specific workforce requirements and funding details for the hubs and school support are yet to emerge.

This time around, leaders noticed Labour’s commitments to mental health improvements were scant in detail, with NHS Providers chief executive officer Sir Julian Hartley stressing its plans need to be backed by “proper staffing and infrastructure”.

King’s Fund policy director Sally Warren warned delivering a commitment to bolster community care “will mean grappling with knotty issues like making careers in community services more attractive… and shifting the balance of investment away from hospital toward community services” - ie paying staff more or taking money out of some services.

MHM is also aware of the concern among mental health leaders about a lack of initiatives to tackle wider mental health waiting lists, which have now reached 1.9m. One of Labour’s headline pledges in Liverpool was to provide staff with £1.1bn in overtime payments to cut the 7.7 million elective backlog. 

Sean Duggan, CEO of NHS Confederation’s mental health network, stressed to MHM the importance of all governments accepting waiting times “are not just relevant for acute services”, adding there are also “unacceptable” waiting times in mental health, especially for children and young people. He noted access to treatment within a month, if delivered by Labour, could reduce waits.

NHS England’s national mental health director Claire Murdoch also weighed in, posting to X (formerly known as Twitter) after the elective care policy announcement that she was “also looking forward to hearing about ideas to tackle the mental health waiting list”.

While some of Labour’s specific pledges are “encouraging”, Mr Duggan said, an overall strategy to address inequalities of people living with mental illnesses — as scrapped by the current government — is still needed. And “stark” concerns about the workforce, with mental health in the perilous position of having the highest nursing vacancies in the NHS, must also be addressed in detail, he added.

While the party appeared to many in Liverpool a government-in-waiting, policymakers are keeping cards close to their chests with the sector hoping for more detailed announcements in the months before 2024’s anticipated general election. 

‘A national emergency’

It comes as Mr Duggan’s boss Matthew Taylor declared mental health care in England a “national emergency”. He warned it has slipped down the current government’s set of priorities, with “patients and services being forgotten”.

“This is a national emergency which is now having serious consequences … not least for those patients in crisis,” he added.

Evidence collected echoed long-standing problems affecting services including inappropriate psychiatric admissions to acute hospitals due to bed shortages, patients waiting days in accident and emergency, and a shortage of suitable community alternatives piling huge pressure on acute pathways.

So deeply rooted are the issues, that throughout Labour’s conference, Mr Streeting made clear timescales for delivery will remain uncertain with most of the party’s health policies expected to take years to progress, with a decade needed to truly turn the tide.

New shadow mental health minister Abena Oppong-Asare, mere weeks into the job, echoed her boss at fringe events and claimed Labour would need to “reverse 13 years of damage” done to mental health services.

She appeared open to policy suggestions and on another fringe panel with Royal College of Psychiatrists president Dr Lade Smith, she pledged to take forward college recommendations for services to implement very early interventions before children turn five.

Dr Smith stressed if medics or parents intervene before five years of age it can often stop youngsters developing mental illnesses. Full recommendations are expected in an upcoming report from the college on infant mental health care.

A Department of Health and Social Care spokesman said: “We’re transforming our country’s mental health services and investing an additional £2.3bn annually (announced in 2019) to expand services so an extra 2m people can get support.

“Our workforce plan sets out the ambition to grow the mental health workforce by 73 per cent and in December 2022 there were 9,000 more mental health staff than the previous year.”

Independent analysis shows funding has increased but has not kept pace with growing demand, and that services have been unable to recruit enough staff, especially nurses.

A National Audit Office report said while the overall workforce increased, nursing numbers grew by less than Health Education England and NHSE’s estimated requirement (by 9 per cent between 2016-17 and 2021-22, compared with an estimate of 16 per cent), compared with the number of therapists and support staff for therapists (for example, a 41 per cent growth in therapists compared to a 25 per cent requirement).

The same report said: ”While funding and the workforce for mental health services have increased and more people have been treated, many people still cannot access services or have lengthy waits for treatment. Staff shortages continue and data that would demonstrate the results of service developments are limited.”