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What’s now known as a “technical recession” has occurred if a country’s real GDP falls two quarters in a row. It was introduced in a 1974 NYT article by the then US Commissioner of Labor Statistics, Julius Shiskin.
The Office for Budget Responsibility (2023, p. 39) says that the UK “narrowly avoided a technical recession in the second half of 2022 as real GDP fell by 0.2 per cent in the third quarter, but was flat in the fourth quarter.”
“Costs and benefits should be calculated over the lifetime of the proposal. Proposals involving infrastructure such as roads, railways and new buildings are appraised over a 60 year period. Refurbishment of existing buildings is considered over 30 years. For proposals involving administrative changes a ten year period is used as a standard measure. For interventions likely to have significant costs or benefits beyond 60 years, such as vaccination programmes, or nuclear waste storage, a suitable appraisal period should be discussed with and formally agreed by the Treasury at the start of work on the proposal.”
The Green Book (2022, p. 9)
I asked Treasury:
Blame for insufficient mental healthcare funding has been passed around between Department of Health, NHS England, and individual Clinical Commissioning Groups (CCGs), however, the source of funding is the Treasury. Although CCGs and other mediating organisations make decisions about how much funding mental health receives, this is as a proportion of budgets decided at Treasury level. Any budgetary planning at Treasury level must therefore take mental health into consideration, alongside other areas of healthcare.
I am writing to request:
(i) names of individuals at Treasury and above, including advisors by official name or function, who are responsible for decisions made in relation to mental health care budgets;
(ii) documentation on budgetary decisions made, including evidence of how, in calculating the total health budget, mental health needs have been taken into consideration.
To (i) they said they don’t hold the information. To (ii) they said they do, but wouldn’t share it, citing Section 35 of the FOI act.
I asked the Department of Health:
CCGs and other mediating organisations make decisions about how much funding mental health receives, but this is as a proportion of budgets decided at Treasury level. Any budgetary planning at Treasury level must therefore take mental health into consideration, alongside other areas of healthcare.
I am writing to inquire about advice provided by Department of Health to Treasury on mental health budgets.
1. Who in DH provides this advice?
2. What advice has been provided to inform the most recent budget allocation for health?
They also confirmed that they held relevant information but refused to share it, citing s35(1)(a).
I asked NHS England the same question:
[…] I am writing to inquire about advice provided by NHS England to Treasury on mental health budgets.
1. Who in NHSE provides this advice?
2. What advice has been provided to inform the most recent budget allocation for health?
They provided a response.
1. Who in NHSE provides this advice?
Paul Baumann, Chief Financial Officer for NHS England, has responsibility for the organisation’s budgets including providing advice on these budgets. NHS England is an Arm’s Length Body (ALB) of the Department of Health (DH), much of the advice the Treasury would receive on Mental Health would be coordinated by the Department.
2. What advice has been provided to inform the most recent budget allocation for health?
NHS England’s view of the overall funding requirements of the NHS were set out in financial analysis conducted for the Call to Action (July 2013) [see, especially, the technical annex] and the Five Year Forward View (October 2014), which have been shared with DH and Her Majesty’s Treasury.
This analysis projects “do-nothing” expenditure using assumptions about the three main drivers associated with current health care demand and costs: demographic growth, non-demographic growth (e.g. technological development and medical advances) and health cost inflation. Historic trends for these drivers were reviewed and an estimation of future pressures developed for six service level ‘assumption sets’: Acute, Mental Health, Specialised Services, Primary Care, Prescribing and non-activity based costs. This high level analysis thus includes assumptions related to cost and demand growth for mental health services as part of the overall modelling.
Detailed analysis and costing is completed by NHS England on specific initiatives, the output of these models are used to inform budget announcements and the planning guidance information. These costings are developed by the Medical Directorate and Finance Directorate working together.