The spring budget – what it means for us
26 April, 2023
In the UK, the news this month has been dominated by the spring budget, which was delivered by Chancellor of the Exchequer Jeremy Hunt in the House of Commons on Wednesday 15 March. From his time as Health Secretary and Health and Social Care Committee Chair, I know he understands the challenges facing the sector.
In his speech, the Chancellor focused on the combined costs of people being unable to work and sickness absence on the wider economy, which poor mental health plays a big part of. The College was pleased that he accepted our recommendation to expand the Individual Placement and Support Programme in England. This evidence-based initiative, when appropriate, can help to get people with severe mental illness into employment which can also aid their recovery.
We were also pleased to see further commitments to update the Suicide Prevention Strategy and also to publish a workforce plan forecasting the number of doctors, nurses and other professionals that will be needed in five, ten- and 15 years’ time. We look forward to seeing these plans when they are published.
We welcome the decision to abolish the Lifetime Allowance as part of the reforms to pension tax thresholds. We know this will be appreciated by psychiatrists across the country - including our colleagues in the devolved nations of in Scotland, Wales and Northern Ireland.
However, the Government must ensure that these promises are supported by adequate investment, and a recognition of parity between mental health and physical health. I know this will continue to be a priority for our engagements with the Government.
Talking about the Major Conditions Strategy
Back In January, the Government announced that it would be bringing forward a new Major Conditions Strategy. Although the College welcomed the Strategy and its inclusion of mental health and dementia, we’re disappointed that the Government also abandoned the Cross-Government Mental Health and Wellbeing plan.
Last week I was invited to speak at the APPG for Health, Chaired by Lord Bethell, to highlight our priorities for the Strategy and was keen to emphasise that we are still far from parity of esteem between mental and physical health. The government must ensure that mental health is not lost in the strategy and it recognises the enormous pressure that services are under. Historically it has not had the same funding or support as other services and so it's vital that mental health gets the support it deserves.
The APPG session also heard from Professor Bola Owolabi, Director of the National Healthcare Inequalities Improvement Programme at NHS England. Tackling health inequalities must be front and centre of the strategy as we know that identifying and reducing inequalities in access, experience and outcomes are essential to the delivery of high-quality mental health care.
It would be amiss not to mention the simultaneous industrial action taking place this month. Junior doctors, alongside other NHS staff, took part in strike action across three days coinciding with the Budget. The past few years have been especially challenging for our junior doctor colleagues, through the pandemic and now facing an ever-increasing demand for services. I’ve recently met with representatives from the Psychiatric Trainees Committee (PTC) and I am really grateful we will continue to have an open dialogue going forward.
As the professional medical body responsible for supporting psychiatrists at all stages of their careers, it is not our role to advise members on whether to take part in the action. We will always be supportive of our trainees and are very much aware of the challenges they face. However, I am confident that if our psychiatrists in training decided to take part, they did so with careful consideration, working alongside our psychiatric consultants and SAS doctors, to balance the potential risks to patient care and service provision, alongside their own wellbeing.
You can read our full statement about industrial action on our website.
This month I’ve had the honour of engaging with some truly inspirational leaders in the mental health sector.
As mentioned in the members update, I had the privilege of meeting colleagues from the Ukrainian Psychiatric Association as part of their annual conference which took place in Warsaw. Amazingly, the conference went ahead despite the extremities psychiatrists are facing in Ukraine. It was incredibly special to hear from Olena Zelenska, the First Lady of Ukraine, who spoke about the importance of good mental health, the need to support each other, the resilience of people and the possibilities beyond the war.
Later, I visited Pakistan to the attend the WPA Thematic Conference, joined by my fantastic colleagues from the British Pakistani Psychiatrists Association. It was a pleasure to discuss some of the global challenges the mental health sector is facing.
Back in the UK, I visited South West London and St George's Mental Health Trust as part of their celebrations for LGBTQ+ History Month. I was invited to tell them about the College’s Equality Action Plan, and in particular, our work around the LGBTQ+ survey that was carried out last year. As you’ll know, the survey revealed worrying levels of discrimination, with one in two psychiatrists experiencing hostility because of their sexuality or gender identity.
The Chair of our General Adult Faculty, Dr Billy Boland, and his colleagues gave me a tour of their new Trinity building which is part of a £150m investment to help transform mental health services in South West London. The Trust is doing some great things around bringing the community into the services and utilising art in care.
The Trust’s Specialist Deaf and Eating Disorder Wards were fantastic to see, and patients are reaping the rewards. It's clear to me that when staff are supported with a great working environment and inspirational leaders who understand the challenges of tackling inequalities, they can truly thrive.
A visit from the CQC
In a series of important dinners hosted at Prescot Street, this month we had a visit from the leadership team at the CQC; Ian Dilks OBE, Chair, Ian Trenholm, CEO and Chris Dzikiti, Director of Mental Health.
I was joined by College Registrar Dr Trudi Seneviratne and colleagues to discuss how the College and the CQC can work together to improve patient safety and quality. The College’s Centre for Quality Improvement (CCQI) has been a real leader in this space – and already has good links with the CQC. It’s clear that our two organisations have a lot to learn from each other.
My home Faculty
As a practising forensic psychiatrist, it was great to be able to give the President’s Address to the Forensic Faculty Conference in Brighton earlier this month. Aside from being able to get a taste of the fresh sea air, this was a great opportunity to reflect on my three years as President of the College and the challenges we’ve all faced – COVID-19 in particular.
I am proud of all my colleagues and their efforts in supporting some of the most vulnerable patients through a global pandemic. I feel it's important to highlight some of the achievements that were so fundamental to us getting out the other side. Thank you also to Dr Josanne Holloway, who has been a phenomenal Chair.