NHS reforms: Ministers wavering after mental health defeat

By Alex Stevenson Follow @alex__stevenson

Ministers may choose not to fight a Lords defeat on the role of mental health in the government's NHS reforms.

Officials at the Department of Health have not yet decided whether they will accept last night's setback and not seek to overturn the amendment when the bill returns to the Commons.

Peers voted by 244 to 240 yesterday evening in favour of a crossbench amendment to the legislation, which places an explicit duty on the health secretary to promote mental and physical health services equally.

"It is time to recognise and act on the plentiful evidence that good mental health underlines all health," Narendra Patel told peers during yesterday's debate.

"Poor mental health is associated with diseases such as cancer, cardiovascular disease and diabetes; and poor physical health increases the risk of mental illness. In the current climate of scarce resources... mental health problems are likely to increase."

At present mental illnesses cost 23% of the 'disease burden', he pointed out, but only account for 11% of the health budget.

Independent crossbencher Ilora Finlay told the Lords that mental health was "critical" and that a "culture change" is urgently needed.

Health minister Earl Howe said they he accepted the "central principle" being argued for, as the government's mental health strategy seeks to give it "parity of esteem" with physical illnesses.

The government's 2011 mental health strategy had stated: "No health without mental health."

But Earl Howe unsuccessful appealed to Labour to withdraw the amendment, offering a concession that the government would clarify the explanatory notes to the legislation to make clear that "illness" refers to both physical and mental types.

Lord Patel said he was "torn" after hearing the minister's assurances, but said he had been persuaded to push the matter to a vote after hearing the argument of crossbencher John Walton.

"What on earth could the objection possibly be to inserting... the unexceptional words listed in the amendment?" Lord Walton of Detchant had asked.

"They simply stress the crucial importance of mental as well as physical illness. How on earth could this be construed as doing any damage whatever to the bill?"

The slim margin of defeat, a majority of just four, leaves the government wavering as to whether it accepts the change or not.

Labour's amendment attracted support from crossbenchers but just three Liberal Democrat peers rebelled.

Mental health charity Mind's chief executive Paul Farmer said he hoped the government would accept the change.

"Any one of us can have a mental health problem, yet despite this, mental health services have been underfunded and overlooked for years,"

"We hope the government stands by this groundbreaking amendment as the bill goes through."

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• mental health
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• nhs reforms