A Spending Review for wellbeing

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Nick O'Shea and Andy Bell

28 July 2020

The 2020 Spending Review is an important opportunity to put people’s health first in the wake of Covid-19.

A Spending Review for wellbeing sets out six key proposals for improving mental health in England, after finding that the cost of mental health difficulties reached a record level of £119 billion last year (2019/20).

The coronavirus pandemic, and the necessary steps the Government has taken to save lives, will have profound and lasting effects on the public’s mental health, and we estimate that at least half a million more people will experience a mental health difficulty this year as a result.

This makes a Spending Review for wellbeing essential for the future health of the nation in the wake of its biggest health crisis for a generation.

The Government has already set out its plans for NHS revenue spending for the next five years, including necessary investment in mental health services. We recommend that the 2020 Spending Review should:

  • Commit to a cross-government approach to better mental health. This could be achieved through a Budget for Wellbeing across all government departments, similar to the approach being used in New Zealand as a robust measure of how government spending impacts on citizen wellbeing.
  • Invest urgently in local authority public health services. Like-for-like spending on Public Health by Local Authorities fell by 8% between 2013 and 2018. Now is the time to invest in local services which are proven to reduce costs elsewhere in the system by preventing mental health problems (especially in the wake of Covid-19) and helping people to secure better life outcomes.
  • Expand access to evidence-based parenting interventions. This can build on learning from the Republic of Ireland, the US and Canada, where governments have invested in progressively-universal programmes which offer support for all with further help to those who need it.
  • Commit to a fair and sustainable long-term social care settlement that includes working age people.
  • Earmark capital funding for the NHS to update its mental health estate, to ensure that high quality inpatient environments and alternatives to hospital admission are available close to home for people with a wide range of needs.
  • Fund specialist counselling for parents who have been bereaved by still birth or baby loss, providing an effective and much-needed national safety net for just £3.2m per year. 
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