It is often said that a lot can happen in a week in politics and this last week before tomorrow's election has certainly been proving that. Different polls have suggested very different outcomes to the election. On 1st June, a Times/YouGov seat prediction suggested the possibility of a hung parliament. This poll gave the Conservatives between 285 and 353 seats, Labour between 219 and 285 seats, the SNP between 35 and 54 seats, the Liberal Democrats between 3 and 17 seats, Plaid Cymru between 1 and 4 seats, the Greens between 1 and 2 seats and UKIP 0 seats (there was no breakdown for seats in Northern Ireland). Another poll by ICM for the Guardian, gave the Conservatives a 12 point lead at 45% to Labout at 33%.
Since 1st June we have seen another terrorist attack and Sunday saw the suspension of national campaigning. The debate has since focused on national security, with Labour and the Conservatives both trying to seize the narrative with attacks on each other's record on national security. We have seen Jeremy Corbyn criticised for his voting against anti-terror legislation. Labour then reminded us that Conservatives including Theresa May also voted against certain measures. Theresa May then faced a barrage of questions on the possible link between police cuts she oversaw as Home Secretary and recent terror cuts. The Conservatives then reminded us that the anti-terror police budget has actually risen. Last night saw Theresa May saying she will rip up the Human Rights Act. Labour has said this is a distraction, and have also announced Diane Abbott has temporarily been replaced as Shadow Home Secretary.
This election has been extraordinary. Many expected a Conservative landslide, and while we do not yet know the result, nobody predicted how difficult the campaign would be for Theresa May. There has also been very little focus on the economy, where the last two elections were almost dominated by debate over it. And where we have seen the rise of other parties in previous elections, this election has almost reverted to another era, dominated by the two horse race between Labour and the Conservatives. The UKIP vote has melted away, the Greens have found it difficult to get their message across, the SNP are expecting some losses to the two main parties, and the Liberal Democrat tactic of focusing on Brexit may have turned off a large number of voters.
The latest poll by ComRes, which successfully predicted the outcome of the 2015 election, also gives the Conservatives a 12 point lead, at 47% to Labour's 35%. ICM now suggest an 11 point lead for the Conservatives, on 45% to Labour at 34%. Whatever the outcome, the BPC will immediately contact the winning party (or parties, in the case of a coalition) to try to influence government policy on behalf of the psychoanalytic community and the many who need greater access to psychoanalytic treatments.
BPC calls on psychological therapies
You may recall that the BPC submitted the following calls to the party manifesto writers:
1. To commit a financial injection comparable to the £1 billion already pledged for adult mental health services, to fund a comprehensive range of appropriate therapeutic offers for the 85% of people with mental health problems (soon to be 75% of people with mental heath problems) not receiving mental health support. We emphasised how practitioners working for IAPT, CAMHS and other existing services are struggling to meet the level of need. We also emphasised that additional money recently pledged by the government for mental health services is not always getting to the front line, and called for ring-fencing of mental health budgets. Above all, we made it clear that people urgently require a more comprehensive range of therapeutic offers, including psychoanalytic psychotherapy and psychoanalytic child psychotherapy, so that they are able to recieve treatment appropriate to their level of need.
2. To introduce a maximum waiting time of 28 days from referral request to first treatment appointment for all children and adults in need of psychological therapy on the NHS. We also asked for a renewed commitment to existing waiting time targets which are less than 28 days, such as for Early Intervention in Psychosis.
3. To ensure that patients receive quality services. By quality, we explained we meant:
- enough psychoanalytic psychotherapists to provide enough sessions to properly help children and adults with mental health problems improve and recover
- people are offered a comprehensive choice of therapies including psychoanalytic psychotherapy – not just a one-size-fits-all approach
- psychotherapists are trained to deal with the complexity of cases they face.
4. To join up health services so that people stop getting lost between children and adult services, and between mental and physical health services.
Here is a reminder of what the parties have to say on psychological therapies:
1. The Alliance Party
Mental health comes under the jurisdiction of the Northern Ireland Assembly. Assembly elections were held earlier this year, however a new executive failed to be formed and Northern Ireland faces the prospect of direct rule from Westminster. The Alliance Party has not yet released a manifesto for the 2017 UK general election.
2. The Conservative Party
We were disappointed to see that the Conservative manifesto makes no mention of psychological therapies at all. No calls submitted by the BPC or professional colleague organisations were included. We did welcome some calls in the manifesto, such as to make the UK the leading research and technology economy in the world for mental health, but our response made it clear that overall the manifesto was disappointing.
3. The Democratic Unionist Party
Mental health comes under the jurisdiction of the Northern Ireland Assembly. Assembly elections were held earlier this year, however a new executive failed to be formed and Northern Ireland faces the prospect of direct rule from Westminster. The Democratic Unionist Party has not yet released a manifesto for the 2017 UK general election.
4. The Green Party
The Green Party manifesto focuses on bringing about parity of esteem between mental health and physicsl health care, on ensuring that people experiencing mental health crises are supported close to their home and support networks, and on increasing mental health awareness. An article penned by Jonathan Bartley, Green Party co-leader, further stated that the Green Party would give mental health the funding it needs, and would ensure anyone needing therapy would recive it within 28 days of referral.
5. The Labour Party
We were pleased to see that Labour's manifesto calls for ring-fencing of mental health budgets, for investment in early intervention, and for the National Institute for Health and Care Excellence (NICE) to evaluate the potential for increasing the range of evidence-based psychological therapies on offer. We have campaigned for years for NICE to increase the range of evidence-based psychological therapies on offer so this last call should be recognised as a significant moment for the BPC.
6. The Liberal Democrats
The Liberal Democrat manifesto includes calls for ring-fencing of mental health funding from a one penny Income Tax rise, for increasing access to clinically and cost-effective talking therapies, and for further roll out of access and waiting time standards for children, young people and adults. This latter call also includes a guarantee that people will not wait more than six weeks for therapy for depression or anxiety, and no young person will wait more than two weeks for treatment when they experience a first episode of psychosis. On ring-fencing, we noted that the Liberal Democrat call does not mean the whole mental health budget would be ring-fenced. In other words, there would not be ring-fencing.
7. Plaid Cymru
NHS legislation in Wales is made by the Welsh Assembly, which will next be elected in 2021. Plaid Cymru's manifesto makes little mention of mental health but does emphasise that it will continue to call for increasing funding and improved access to trained psychotherapists and counsellors. The BPC will liaise closely with Plaid Cymru well in advance of the 2021 election to put the case for much greater provision of psychoanalytic psychotherapists on the NHS in Wales.
8. The Scottish National Party
NHS legisliation in Scotland is made by the Scottish Parliament, which will next be elected in 2020. The SNP's manifesto makes no pledges on mental health of relevance to the UK but it does refer to its 10 Year Mental Health Strategy for Scotland, which comes under the jurisdiction of the Scottish Parliament. This Strategy includes increasing the mental health workforce and improving delivery of child and adolescent mental health services. The BPC will be liaising closely with the SNP and with other parties in order to influence the manifestos for the Scottish Parliament election.
9. Sinn Fein
Mental health comes under the jurisdiction of the Northern Ireland Assembly. Assembly elections were held earlier this year, however a new executive failed to be formed and Northern Ireland faces the prospect of direct rule from Westminster. Sinn Fein has released a manifesto for the 2017 UK general election. The only reference to mental health is 'to resist Tory cuts to health care and mental health'.
10. The Social Democratic Unionist Party
Mental health comes under the jurisdiction of the Northern Ireland Assembly. Assembly elections were held earlier this year, however a new executive failed to be formed and Northern Ireland faces the prospect of direct rule from Westminster. The SDLP has previously pledge to ring-fence funding for mental health so it is protected from any budget cuts. No specific manifesto has yet been released for the 2017 UK general election.
11. The UK Independence Party
UKIP's manifesto has included calls to introduce a 28 day waiting time between referral and first appointment for psychological therapy, to end the gap between child and adult, and physical health and mental health services, and for funding earmarked for mental health services to only go to mental health services. We note that this final call also stops short of calling for actual ring-fencing of mental health budgets.
12. The Ulster Unionist Party
Mental health comes under the jurisdiction of the Northern Ireland Assembly. Assembly elections were held earlier this year, however a new executive failed to be formed and Northern Ireland faces the prospect of direct rule from Westminster. The Ulster Unionist Party has not yet released a manifesto for the 2017 UK general election.
Perhaps the best prediction for this election, even with less than two days until we know the result, is not to make a prediction. Many of the most experienced political pundits have on this occasion refused to do so. Whatever the outcome, the UK will face major changes, either embarking on what is likely to be an increasingly hard Brexit and further austerity (and what that may mean for public services) or a rebuilding of the welfare state and our public services. A third possible scenario is Labour in coalition with the SNP, which would surely mean agreeing to a second Scottish independence referendum.
We will be releasing a further briefing after the election, analysing what happens next for the winning and losing parties and what the outcome means for the BPC and above all for the psychoanalytic community.