With a week to go until the general election, it would be understandable if you were already rather fatigued by the 24/7 press coverage and campaigning. The run-up has at times been wildly unpredictable - with all parties experiencing blips and some recent polls suggesting the Conservatives may not win an overall majority.
At the time of writing, a Times/You Gov seat projection has suggested that there will be a hung parliament with the Conservatives losing 20 seats, Labour gaining 28 seats, the Liberal Democrats gaining 1 seat, the SNP losing 4 seats and Plaid Cymru and the Greens staying on 3 seats and 1 seat (there is no breakdown for seats in Northern Ireland). The Times/You Gov does note, however, that there could be large variations, with the Conservatives gaining between 274 and 345 seats. A separate poll by the ICM for the Guardian, gives the Conservatives a 12 point lead at 45% to Labour at 33%. The cliche that a week is a long time in politics may be rather apt for the next week and despite most polls in recent weeks predicting a Conservative majority government, I would not wish to be making a bet on any particular outcome.
Perhaps more than any other general election in living memory, this is an election based around momentous issues facing the UK. What will be our future relationship with Europe? What will be our role in the world? With the changing nature of threats to the UK, what shape will our defence policy take? How can the NHS be made fit for the 21st century? How can we rise to meet the challenge of an ageing population? How can we make a more equal society? How will we deal with the changing climate? There is no easy answer to any of these questions and at various times all parties have foundered in attempting to offer solutions.
Mental health and psychological therapies
With so many great matters under scrutiny, one may well wonder if mental health has been seriously considered by the parties. Within days of the general election being announced in mid-April, we were in close liaison with party manifesto writers and submitted, both individually and with a number of colleague organisations, various calls to the political parties. Over the past few weeks, the BPC has been reporting what party manifestos have said on mental health and, above all, on the overall subject of psychological therapies. We have been delighted to see that most of our calls have been taken up. As a reminder, our calls to the parties were:
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 psychotherap, 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.
What do the parties offer?
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. Should the Conservatives win the election, we will of course continue to press our calls.
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.
We will be releasing a further briefing before the general election and further ones after the election, analysing what next for the winning and losing parties and what the outcome means for the psychoanalytic community.