Dear Tulip Siddiq,
I submitted a series of Freedom of Information (FOI) requests to Treasury, Department of Health, and NHS England, asking:
(i) Who is responsible for decisions made in relation to mental health care budgets?
(ii) How are budgetary decisions made, including evidence of how, in calculating the total health budget, mental health needs have been taken into consideration?
Treasury and DH both replied citing s35 of the FOI act. Releasing discussion of options available, Treasury argued, might inhibit future “rigorous and candid assessments of options available” . DH replied similarly: “Premature disclosure of information protected under section 35 could prejudice good working relationships, the neutrality of civil servants” .
NHS England did reveal something of their decision making processes, naming Paul Baumann, Chief Financial Officer for NHS England, as responsible for budgets, and citing a technical document , the technical annex of which  sketches an estimate of likely growth in mental health costs over the coming years.
But Treasury and DH’s responses indicate that other factors have been taken into consideration that are not currently in the public domain. A rigorous debate about options, involving the people who need mental health services as well as those who provide them, requires transparency.
I am therefore writing to ask for more information concerning the reasoning behind decisions made. In particular, what discussion has there been of the following?
(i) The effectiveness of mental healthcare treatments and support, in comparison to physical health care;
(ii) The costs of the various treatments; and
(iii) The potential for reducing costs, e.g., by employing lower band staff or increasing involvement of voluntary services.
It is important that reasoning on these issues is made public so they can be openly debated.
Dr Andy Fugard