Parity: where is it?

The principle by which mental health must be given equal priority to physical health is known as Parity of Esteem and was established in law by the Health and Social Care Act 2012. NHS England, through an NHS mandate, is required to work for parity of esteem with regard to mental and physical health. It is clearly laid out what it is that the NHS and commissioners need to do in order to deliver improvements in the way long-term conditions are treated and how health inequalities are addressed. Expanding access to psychological therapies and services, addressing access and waiting times for mental health care, and commissioning integrated support for those with coexisting physical and mental health conditions are examples of some actions. In some areas this is just not happening.

The Care Quality Commission (CQC) regulates all health and social care services in England. It also produces an annual report on the use of the Mental Health Act (MHA) determining how providers are caring for patients, and whether patients’ rights are being protected (CQC, 2019a). The CQC's remit includes independently run organisations. Significant numbers of privately run mental health units have been deemed ‘inadequate’ by inspectors in the past 3 years—such findings could mean that vulnerable patients are receiving substandard and potentially unsafe care. So far this year the CQC has rated 16 independently run mental health units as inadequate. In 2018 it had put four others in the same category and eight in 2017. A number of privately run mental health units are occupied by NHS-funded patients, who may spend months or years there.