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A chance to curb the nursing crisis or yet more best-laid plans?

The Budget’s bold mental health strategy is welcome, but without proper staffing it could go the way of many other well-meaning initiatives, writes Marilyn Eveleigh


Philip Hammond’s Budget promised the end of austerity. Was it for real or just more rhetoric? 

It certainly resonated with the public. 

For healthcare, the headline news was more cash for mental health services. He announced the next 10 years will see the creation of a mental health crisis service in every A&E, each with a 24-hour crisis hotline and a children and young people’s crisis team. 

Many have welcomed these measures – included as part of the NHS 10-year plan – because they go some way to establishing a much-needed parity with physical healthcare. However, past experience indicates the funds must be ringfenced for mental health if the promise is to be delivered. 

All healthcare organisations, policy-makers, employers, unions and media have questioned how the goals will be achieved with a dramatically dwindling mental health workforce. In the past eight years, 5,000 mental health nurses have left the profession – a 12% drop in staffing. 

An All Party Parliamentary Group recently confirmed that core mental health services were under severe strain and there is an urgency to attract new recruits into mental health and retain existing highly-skilled staff. One of its priorities was that all health professionals in frontline services, including nurses, require a greater knowledge of mental health.

So will the new mental health strategy effectively decelerate the nursing workforce crisis that is draining energy, talent and goodwill? 

At present, it seems unlikely: nursing students are incurring debts of £9,000 a year with no maintenance grants, for spending only half the year at the university as the rest is unpaid working in a clinical placement. Only to join one of the lowest paid professionals in the UK, one mired by confusion over new nursing roles, a plethora of new educational standards and the loss of training funding streams. None of this beckons many to the profession.

If nurses are not attracted to work in the NHS, not much will improve in any of the healthcare services. 

I sincerely hope a recent investigation by The Times into the exorbitant profitability of private psychiatric services solely from NHS patient funding will fuel an outcry. This may seem simplistic, but it appears the Government is prepared to pay independent profit-making providers for mental health services but until now, has been unwilling to invest sufficiently in NHS providers. Securing an appropriate mental health nursing workforce poses a potential risk to the new, ambitiously enhanced mental health service - and to the reputation of the Government. 

As a society, we need to value nurses by paying them a decent wage. Better pay would boost staffing, improving job satisfaction, clinical quality and patient safety. 

This is real, not rhetoric.