Does the Labour government still care about mental health? Recently, it dropped its NHS targets for mental health, along with other targets on dementia diagnoses and women’s health. Today at Health questions in the Commons, ministers were confronted about whether they were still committed to improving treatment for mental illness, given the targets are now gone. Stephen Kinnock argued:
‘What we know about targets is that if you try and overload a system with too many targets, it causes confusion, and you end up with, as she rightly says, perverse outcomes. And so we are very clear that we want to not have a system which is based on just making policy by press release, as was the case under the previous government, putting out press announcements, loads of them, for more targets. It all makes for nice front page headlines, but it doesn’t actually lead to any serious delivery of the strategy that we need to deliver…. We are absolutely committed to mental health, as set out in the planning guidance. It is one priority for the planning guidance, and we will continue to deliver to that priority.’
The focus on cutting waiting lists and reducing the number of targets is, as Kinnock argued, designed to stop the NHS from being so crowded. Targets themselves don’t always work very well: the NHS has been missing its four-hour waiting target for A&E for more than ten years, for instance. Enforcing those targets can create perverse incentives for the service to behave in ways that don’t actually help patient care, either, because staff are so worried about the target that they don’t do what is necessary to treat the patient.
But many of the targets that have been dropped were designed to ensure earlier diagnosis and treatment so that people stayed out of hospital. Alongside the immediate desire to cut waiting lists, keeping people out of hospital as much as possible is apparently the overall ambition of ministers. Yet most of the retained targets seem focused on hospital care, rather than preventive and community services.
We don’t yet have the ten-year plan for the NHS where ministers explain how they are going to deal with that paradox. It is still being written, but is apparently not far from draft form. For now, we haven’t seen much evidence that ministers quite know how to manage to turn the NHS from being a hospital-focused service into one that helps prevent ill health and treats more people in the community.
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