Nick Clegg will, as promised, use his conference speech today to announce waiting time targets for mental health treatments. The Deputy Prime Minister, as part of government efforts to bring mental and physical health onto an even keel, introduce targets for the first time and pledge some (although not very much) more money to help this happen.
The announcement is partly future party policy and partly immediately effective government policy. The latter includes £120 million to improve the services so that they match up to these targets, which apply from April 2015. Clegg will tell the conference:
‘This morning I announced that next year, for the first time ever, we will introduce national waiting times for patients with mental health conditions. Labour introduced waiting times in physical health – we will do the same for the many people struggling with conditions that you often can’t see, that we often don’t talk about, but which are just as serious.
‘So if you are waiting for talking therapies to help with your depression, you will be seen within six weeks – 18 weeks at an absolute maximum – just as if you are waiting for an operation on your hip. If you are young person experiencing psychosis for the first, you will be seen within 2 weeks, something we are going to roll out across the country – just as if you suspect you have cancer.
‘If you are having a breakdown, if you are thinking of harming yourself, for any emergency which takes you to A&E, you’ll get the help you need – just as if you had gone to hospital with chest pains or following an accident. These are big, big changes. And in Government again the Liberal Democrats will commit to completing this overhaul of our mental health services – ending the discrimination against mental health for good.’
The Lib Dem leader will also promise that this will be on the front page of the party’s manifesto as one of a limited number of priorities that he will push for in coalition negotiations.
The implications for this in terms of policy and politics are quite different. The impact for the first is enormous, the second not so much. First, the policy. This is very ambitious – in both a complimentary and critical sense. On the one hand, it would be churlish for anyone who complains about the waiting times for mental health treatment to moan about a party setting an ambitious target. It is excellent that Clegg is making mental health such a central part of his pre-General Election pitch when it has indeed been so badly neglected.
The reason this is ambitious is that currently the ‘Cinderella’ mental health service that the Deputy Prime Minister will describe is very, very far away from the service he wants. Currently one in 10 patients waits more than a year to start a talking therapy. Only one in three people with depression receive the treatments recommended by NICE for their condition. The Lib Dems could have made it easier for themselves by setting the target for talking therapies as patients being ‘seen’ at an assessment to discuss their suitability for the different talking therapies within a maximum of 18 weeks. Currently patients can receive that assessment and then sit on a waiting list, deteriorating, for many months before their first session of cognitive behavioural therapy. But Clegg’s pledge is that patients start their treatment within the 18 week period. It is so ambitious that it is likely many trusts will miss their targets for a while, though the Lib Dems say they have set targets that NHS England says are realistic.
As for the politics, this is not a surprising challenge-the-core and shock-the-wider-voting-public strategy. Improving mental health services is something Clegg has campaigned on for years, so his announcement tells us nothing more about the party. Making this a policy red line for coalition negotiations is almost meaningless as no party is going to disagree with it. That this could be the main new red line to emerge from the Lib Dem conference does tell us what sort of frame of mind they are in about Coalition, though: they haven’t set anything that the Tories can’t sign up to, or for that matter Labour.
But the reason this is the main pre-briefed announcement is that it works very, very well with the small group of voters that Clegg and his strategists are focusing all their energies on. I understand that when it was tested in this Lib Dem ‘market’ it was the 5th most popular policy from the party’s pre-manifesto. It also plays very well in the party’s seats. So if the Lib Dems just want to encourage the voters who have a chance of backing them in a few months’ time to do so, then this makes complete sense.