Fairytale tax cuts threaten mental health services that are already inadequate

Editorial: The NHS and social care will be further undermined by unrealistic election promises

The NHS as a whole is in a parlous state (Getty)

There will be more cases like that of Ben Craig – a mental health patient who was well enough to leave hospital, but who was stranded on a ward for two years – if the next election becomes a Dutch auction of tax cuts.

Of course, Jeremy Hunt’s cut in national insurance contributions is not a real tax cut, in that it will be offset by the rising burden of overall taxation. But it is taking real money out of public services that would otherwise be available.

As we report today, and have been reporting in recent weeks, NHS mental health services are in no state to have their budgets squeezed. Mr Craig’s story, which Mind, the mental health charity, says is far from unique, is likely to be repeated far too often in the years to come. The NHS needed his bed but was unable to discharge him as two local councils fought over which should pay for his supported housing. As a result, the cost to the taxpayer of keeping him in hospital was far more than that of supporting him in the community.

This is what happens in a system that is under-managed, badly coordinated, and under-resourced. False economies end up damaging patients – Mr Craig says he feels “scarred” – and costing the taxpayer more, making it harder to fund even basic care for other patients.

This month, The Independent has reported on the “inhumane” treatment of people with learning disabilities, some of whom have been held in hospital for decades because there is nowhere to house them in the community. A week ago we reported on the plight of mental health patients dumped in A&E departments who sometimes have to wait five days before they are treated.

And these reports are just about mental illness in the NHS. At least one recent prime minister, Theresa May, said some brave words promising parity of esteem between mental and physical ill health. We did not think she meant that the rest of the NHS would be brought down to the level of neglect suffered by its mental health services, but that is the only sense in which her words might have prefigured reality.

The NHS as a whole is in a parlous state, and although the social care sector has been rescued by the recent increase in immigration, coordination between social care and the NHS remains poor.

In this context, an election campaign fought on the issue of tax cuts seems almost tasteless. Rishi Sunak and Mr Hunt are clearly so desperate that they think the only way to save anything from the wreckage of their impending engagement with the voters is to cut some visible taxes now and to promise more cuts afterwards.

At a time when most people do not want cuts in public services, and most people recognise that the public finances are far from repaired after the emergencies of coronavirus and energy price support, this is a core vote strategy. It is aimed at the sort of people who thought that Liz Truss had the right idea, cutting taxes without any plausible means of balancing the books.

Mr Sunak and Mr Hunt, who rescued the country when Ms Truss sent the financial markets into meltdown, are now taking only slightly smaller risks with the public finances in the hope that they can hang on to enough votes to avoid an electoral wipeout.

Unfortunately Sir Keir Starmer, the Labour leader, and Rachel Reeves, the shadow chancellor, say that they support the tax cut announced in the autumn statement, even if it is outweighed by tax rises elsewhere, and even though it will mean less money is available to start the huge task – most of which will probably fall to them – of rebuilding the NHS.

If the Labour Party were serious about ensuring that people like Mr Craig are not left “medicating and drifting” on hospital wards, in the words of one senior NHS source speaking to The Independent, it would say that now is not the time for tax cuts. If Sir Keir, Ms Reeves and Wes Streeting, the shadow health and social care secretary, were serious about turning the NHS around, they would say that now is not the time for tax cuts.

It will be a test of the maturity of our political culture if Labour can resist being dragged into an election campaign in which both main parties compete to offer unbelievable promises.