RCPsych Wales - Parity across the land

Insight into RCPsych’s campaign for parity in Wales ahead of May’s Senedd and Scottish Parliament elections.

This blog is an extract from RCPsych's Insight Magazine Spring edition.

This is an election year like no other. On 6 May, socially distanced voters will navigate COVID-19 to cast their votes in elections across England, Scotland and Wales. Public health, both mental and physical, will be front of mind for many.

There are no elections this year in Northern Ireland, but all the seats in the Scottish Parliament and Welsh Senedd are up for grabs in May. The devolved nations control their own health budgets, so the choices made by voters will directly influence future health spending priorities. RCPsych has launched two manifestos in the run-up to the parliamentary elections in Scotland and Wales, both of which put parity between mental and physical health at the heart of their proposals.

The Welsh manifesto, entitled Good mental health for Wales, calls for “a sea change in the way mental health is prioritised and funded in Wales”. Spending on mental health services per head of the population in Wales is lower than in the other devolved nations. RCPsych is pressing the Welsh government to ensure that spending on mental health and learning disability services is increased to at least 13% of its overall budget.

It is also calling for wellbeing to be “the principal aim of the budget”, along the lines of New Zealand’s Wellbeing Budget introduced in May 2019. The idea is that all departments of government make wellbeing their top priority when making spending decisions.

”There’s a strong feeling within mental health services that a wellbeing budget would work very well,” says Dr Katie Fergus, a rehabilitation psychiatrist based in Cardiff and RCPsych’s policy lead in Wales. It’s a view that seems to be widely shared. “We’ve met with all the major political parties to discuss the manifesto,” says Dr Fergus, “and it’s been very well received.”

The manifesto is the latest in a long line of interventions made by RCPsych in Wales. “We enjoy a very good relationship with the Welsh Government,” says Dr Fergus, citing regular discussions, as well as requests for presentations on a wide range of issues. 

The College also works closely with the Senedd’s Health, Social Care and Sport Committee, whose chair for the past five years has been Dr Dai Lloyd, Plaid Cymru Member of the Senedd for South Wales West. A former GP, he says he “immensely enjoyed” the six months he spent as a psychiatry SHO when he was training. “Mental health has always been high up on my own personal agenda and I’ve always felt it lost out to physical health. So, for the whole five years, the health committee has insisted that we consider mental health alongside physical health.”

He points to a raft of inquiries carried out by the committee into, among other things, loneliness and isolation, suicide prevention and the use of anti-psychotic medication in care homes. The committee’s latest report, on the impact of COVID-19 on mental health, is currently awaiting a response from the Welsh government.

Both Dr Fergus and Dr Lloyd agree that progress has been made in recent years, with increases in funding for mental health services and greater awareness. Last autumn, the Welsh government created a new cabinet post, that of Minister for Mental Health and Wellbeing, a development Dr Fergus welcomes as “very positive news”. RCPsych recently met with the minister and had “a very helpful conversation, which, we hope, marks the start of a constructive dialogue.”

Dr Lloyd credits the work of his committee for the advances that have been made, “though I would say that wouldn’t I?” He concedes that the Health Minister may have played a part, which is high praise from an opposition politician.

Dr Fergus pays testament to the work that the College has been doing in raising its profile and its voice to advocate for the needs of people with mental health problems. She is confident that RCPsych’s influence will continue to be felt during the forthcoming election campaign. “We’re certainly anticipating having quite a high profile over the next few months,” she says.