Mental health care must not be overlooked in our fight to save the NHS

One of the most alarming of many alarming signs of a dysfunctional nation is that young people seem to be leaving the labour market because of mental illness. As Keir Starmer, the Labour leader, said in his speech to the Confederation of British Industry on Tuesday, “the state of our public services is an economic crisis just as much as a social crisis”.

As we report today, the National Health Service is struggling on all fronts, and mental health services are no exception. It seems as if it were a different country, in a different era, when Theresa May as prime minister promised parity of esteem between mental and physical health services. In the current crisis mental illness is too often an afterthought, when politicians wring their hands about ambulance response times and hospital discharges into social care.

That is why we are proud of our reporting of the often shocking state of provision for people suffering mental illness. Rebecca Thomas, our health correspondent, reports on cases including a patient who stayed for eight days on a mattress in an A&E department before a bed could be found on a ward.

Many patients with less serious conditions are lucky if they are ever seen at all, or have to wait, sometimes for years, for treatment. Often, the only way to obtain treatment on the NHS is for the illness to worsen to the point of crisis. This is not an acceptable way to run a modern, compassionate health service.

Of course, we recognise that the problems of the NHS are system-wide. Just as mental illness needs to be treated by looking at the whole person, mental health services cannot be fixed without fixing the whole of the NHS. If the NHS works better, all parts of the NHS can work better.

So The Independent does give the prime minister and chancellor credit for taking some of the right decisions in the autumn statement, increasing real-terms funding for the NHS and for social care. Until the bottleneck of discharges to social care can be unjammed, everything in the NHS is going to be slowed down.

The Independent has consistently argued that high-quality public services have to be paid for, and that, in the long view, taxes are too low in this country and public services are under-managed.

We are concerned that the No 10 delivery unit, a Tony Blair innovation revived by Boris Johnson, was abolished by Liz Truss and has not been reconstituted by Rishi Sunak. Mr Sunak said many of the right things during his campaign for the Conservative leadership during the summer about the need for prime ministerial “grip” of the NHS backlog problem, but without a mechanism for setting targets and pursuing them rigorously, talk about delivery is just talk.

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Those targets should include a small number of targets for mental health waiting times and outcomes. The evidence from the New Labour era – the one time in its history that the NHS came close to working as well as it should – is that a focus on a few well-chosen targets raises performance throughout the whole of the NHS.

Steve Barclay, the health and social care secretary, and Maria Caulfield, the minister for mental health, should make it clear to Mr Sunak that they would welcome his interference in their department. It is only by a team effort driven from the top of government that the NHS has any chance of being turned in the right direction within the timetable that politicians worry about, namely before the next election.

They have a huge task on their hands, but the recovery of mental health services must be an integral part of the recovery of the NHS as a whole.