Towards a Mental Health Pledge Card

Mental Health


One component of Labour’s 1997 campaign was the ‘pledge card’ – five succinct, specific pledges, detailed in the manifesto and circulated on a small card. The approach was deployed again in 2001 and 2005. Pledge card politics do not automatically equate to Blairism.

So what could a mental health pledge card at the next general election highlight? Here are some ideas:


The marketization of NHS and local government mental health services has left many areas with dis-integrated services, characterised by a wide array of organisations stoutly defending their boundaries and their bottom lines. As well as being a breeding ground for inefficiency and poor service user experience, this leads to continuous confusion for everyone involved in the sector, including GPs, voluntary organisations and carers. Instead we need an unambiguous commitment at leadership level for a shift towards seamless services, with commissioners and providers explicitly incentivised to redesign pathways that genuinely put service users at the heart of everything.


The mental health investment standard now needs to be given teeth, with government taking powers to sanction commissioners who fail to meet the standard. CAMHS is one area that would especially benefit from commissioners reading the parity memo. And parity cannot be restricted to the NHS – there is an urgent need for the disinvestment in local government mental health social care to be reversed and rectified.


As a nation, we are currently spending £34 billion a year on mental health services, when we know that the overall annual cost of mental ill health is about £105 billion. There is the business case for serious investment in an ongoing, high profile national mental health promotion campaign, in schools, workplaces and beyond, drawing on international best practice. Our aim should be nothing less than a fundamental and irreversible shift in mental health services towards prevention and recovery.


Nothing about us without us” needs to be wrestled out of the Lansley cliché archive and instead deployed in the spirit in which it was intended. What is the argument against every mental health provider board including an expert by experience? Is it time to improve and elevate the service user survey to something more similar to HCAHPs in the USA, where the combined weight of service user opinion is utilized to make real differences to funding?


Quality services rely on a skilled, consistent, well trained workforce. Far too much of the scarce mental health budget is going into the pockets of hedge fund backed agencies. The systematic cuts in real pay for staff have directly resulted in high vacancy rates and excess reliance on agencies in health and social care. Modern mental healthcare relies on effective team working, which is much harder to deliver when such a high proportion of the workforce is temporary. A fair pay deal would slash the agency bill in short time.

Dave Lee is a member of the Socialist Health Association and writes in a personal capacity.