The Birmingham judgment has far-reaching implications, both for legislators and for local councils (Council's plan to cut care for disabled ruled unlawful, 20 May). In recent years, governments have been anxious to enshrine many rights into law and, while we applaud this because it gives protection to vulnerable people, there is also a commensurate responsibility upon governments to resource their aspirations. Social care departments are some of the biggest areas of discretionary spend within a local authority budget and as the financial position worsens, it is often to cuts in social care that councils turn to balance their budgets. This situation places both service users and councils in a difficult position. The time may now be right to place the social care budget in a ringfenced pot, similar to that of education, to ensure that the money allocated for care actually gets to vulnerable people.
Martin Green
Chief executive, English Community Care Association
• The pause in the health and social care bill offers the chance to attend to concerns which remain to be addressed (Report, 20 May). We are disappointed that the place of mental health is still largely invisible. Providing treatment for mental health costs more than any other single area of care, at more than 10% of the NHS total budget. It costs more than cancer and coronary heart disease put together. Over a lifetime, more than one in three people will seek care for mental health problems, roughly the same proportion as those developing cancer, but with considerably more stigma, cost and social burden. A recent Department of Health study found that in England alone the total economic and social impact is estimated to exceed £100bn – 10 times the direct healthcare costs. It quantified mental health as the largest single cause of disability in the UK, amounting to 23% of the overall burden of the disease.
In the face of these facts, it is simply not acceptable for mental health to continue to lie under the radar during this legislative pause. If we are to enable GPs to commission effectively for the single most costly area of healthcare, then we should start by placing it centre stage, tackling unwarranted variation, and increasing efforts to eliminate the stigma and discrimination that blights the lives of those affected by mental illness.
Dr David Welbourn Cass Business School, Professor Dinesh Bhugra Royal College of Psychiatrists, Victor Adebowale Turning Point, Paul Jenkins Rethink, Steve Shrubb Mental Health Network, NHS Confederation, Dr Rob Warwick Cass BS, Professor Julienne Meyer City University, Dean Fathers Cass BS, Dr Myriam Lugon Matrix Knowledge Group