Mental health is losing out in Scotland

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The government says it is prioritising mental health. But Richard Norris says that in Scotland less money is being spent on mental health than other health areas.

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A new report from Audit Scotland has provided further evidence that spending decisions at local level are not reflecting the priority for mental health that the Scottish Executive wants to see.

Audit Scotland’s report - “An overview of the performance of the NHS in Scotland” attracted widespread media coverage for supposedly depicting the NHS as a ‘black hole’ in which large sums of money were disappearing without monitoring or evaluation.

This slant was unfair - the report was more positive than that, but the report did note that it was “difficult to quantify the benefits from higher healthcare spending in Scotland because of the failure of information to keep up with changes in healthcare delivery.”

The report also noted that the executive was likely to meet its targets for cancer, coronary heart disease and stroke (which along with mental health are the NHS clinical priorities).

On mental health the report had some interesting statistics.

In the year 2002/3 NHS boards spend “nearly ?800 million on mental health services, an increase of 2% on the previous year.”

However, further enquiries by the Scottish Assocation for Mental Health (SAMH) have revealed that overall NHS spend that year went up by over 6% in real terms (i.e. after inflation had been taken into account).

The 2% figure for mental health however does not allow for inflation - and the rate of inflation during that period was 2.08% .

So at a time when general health spend was going up by over 6% - mental health funding was going slightly down in real terms.

There are some caveats that need to be remembered - Audit Scotland also noted that councils planned to spend ?52 million that year, apparently significantly higher than previous years.

There was also extra money (?20 million) through mental health specific grants and the ?17.1 million for new mental health legislation - but this is all money either ring fenced or spent centrally - not by local health boards.

Moreover, the ?800 million spend by boards included money for learning disabilities - and the true figure for mental health according to one source I spoke to is probably closer to ?500 million.

All in all, it looks as though spending decisions at local level are not reflecting the priority for mental health that the government has been urging.

It is for this reason that SAMH has been calling for more ring fencing of mental health monies.

Richard Norris is director of policy at the Scottish Association for Mental Health

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