Mental health care in an age of austerity

At the time of writing this book, a right-wing government in the UK has put all of public spending under huge strain. Central government financial support for local authorities has been substantially reduced, and social services are under considerable strain. Because of the great affection shown by UK citizens towards their health service - the NHS - government ministers have pledged to protect the funding for the health services (a pledge that, remarkably, seems not yet to have been broken). It seems to be a matter of pride to some in government that the UK is planning to reduce the funding for public services to a level not seen since 1948.3 I must say that this is a matter of concern, if not shame, for me. All this means that local authorities are, as I write this, under unprecedented financial pressure. It is in this context of financial pressure that many of my colleagues have been concerned about the transfer of public health services to local authority control. The argument is that it is much better to keep such services within the ring-fenced NHS budget than to expose them to the pressures of a shrinking local authority funding model.

Whilst this is an important concern in the current UK context, it does not negate my wider argument. The temporary details of public service funding in the UK in 2014 should not prevent a larger debate about what the appropriate ethos and service model might be for mental health and well-being services more generally. In my opinion, any concern about the funding of and costs of services makes the case for integrated care even more strongly. To save unnecessary costs, we should do it right, first time, every time.

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