Opinion: changing the NHS spending ratio

finance-iconMental illness is now nearly 50% of all ill health suffered by people in Britain aged under 65, and accounts for 23% of the total burden of disease.[1] At any one time, about 16% of adults and 10% of children are affected by common mental disorders such as depression and anxiety.[2]

It therefore cannot make sense for the National Health Service in England to spend roughly seven times as much on bio‑physical healthcare compared to mental healthcare. This situation is even more astounding given that many bio-physical illnesses are lifestyle in origin and thus can best be prevented or alleviated through psychological (rather than bio-physical) means.

When it comes to local authorities, the imbalance is even worse – far worse in fact. Mind, the mental health charity, has found that local authorities in England spend an average of just 1.36% of their public health budget (which is separate from the NHS England budget) on mental health … despite having a remit to prevent both physical and mental health problems in the communities they serve.[3]

But perhaps this is not surprising considering that, when reporting on spend for different public health priorities, local authorities file public mental health under ‘Miscellaneous’!

Materialism makes for imbalance:

In the personal opinion of the author, the main reason for this spending imbalance – however irrational – is the materialist orientation of the wider governmental/philosophical/cultural system in which healthcare is currently embedded. Put simply, the bio-physical is deemed to be far more important than the psychological and emotional.

This is partly because:

  • The bio-physical is more directly observable and tangible, and thus more easily measurable. A materialist system tends to value such attributes, and to under-value or even ignore altogether things – like the psychological and emotional – which are less tangible and more difficult to measure.
  • Bio-physical health is deemed more vital – in terms of employment and productivity – for maximising national economic growth … an objective which a materialist system values above all else.

But even in materialist terms the current spending-ratio imbalance makes no sense. According to a 2013 briefing[4] from the Economic & Social Research Council, depression, anxiety and other psychological conditions cost the UK an estimated £77 billion a year in terms of lost workdays and healthcare costs.[5]

Richard Oldfield (writer and policy developer)

 

[1] Economic & Social Research Council: “Cutting NHS costs with mental health investments”.

[2] The Foresight Mental Capital and Wellbeing Project report (2008).

[3] From Local Authority Revenue Expenditure & Financing 2014-15 Budget: England.

[4] “Mental health and social relationships” (May 2013).

[5] Alternatively, the Foresight Mental Capital and Wellbeing Project report estimated in 2008 that the costs were about £77 billion per year for England alone when wider impacts on wellbeing are included (more than the total costs associated with crime), or £49 billion for economic costs alone.

Opinion: changing the NHS spending ratio
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