Spending Review: our analysis, with a lot of help from our friends

Earlier this month, the Chancellor set out spending plans for this government in the Spending Review. While we wish it wasn’t the case, money plays a huge part in preventing people from having traumatising experiences; preventing people from having to remain in traumatising situations for long periods of time, or having to be repeatedly retraumatised; and giving people options to grow into the lives they want to live post-trauma. How the Spending Review has panned out, therefore, gives us a lot of clues as to what situations might improve for survivors over the next few years, and where more attention will be urgently needed. It is also a valuable measure of what issues are on the political radar and which are currently falling through the cracks.

So many topics are relevant to survivors and we won’t try to pretend to be able to do economic analysis of them all - so we have collated thoughts that have been shared by a number of other organisations below on where they believe the Spending Review leaves us in their areas of expertise.

On the whole, as an arts in mental health organisation, a Spending Review that increases NHS spending by 3% in real terms each year while cutting Culture, Media and Sport (DCMS) spending by 1.4%, leaves us very torn - and that sets the scene well for our responses to other areas as well.

Mental health (source: Centre for Mental Health)

As stated above, there is reason for optimism around health spending in general in this Review. There has also been assurance of a nationwide expansion of school Mental Health Support Teams, which may fulfil the government’s pledge from their manifesto to place a mental health professional in every school in England. This, however, is the only specific commitment to mental health mentioned, with no corresponding reference to the other mental health-related pledges in the manifesto such as early support hubs for young people and reforms to the Mental Health Act.

This is somewhat disconcerting, considering that the NHS Long Term Plan through which significant funds were directed centrally by NHS England to implement specific pledges (including those related to mental health) has come to an end - and the future of the Mental Health Investment Standard, that holds integrated care boards to account for maintaining their share of spending on mental health services, is uncertain. Historically, when there have been huge pressures on NHS budgets in several areas as there are now, funds have been diverted away from mental health services when the government has not put requirements related to mental health on commissioners.

As so many survivors know, it is impossible to measure the efficacy of a country’s mental health support systems without also considering the efficacy of its social care systems. So many of us have experienced the devastation that is caused when adult social care and the NHS can’t work effectively together - and their doing so depends on each side having the necessary resources to fulfil their responsibilities. With the use of the funding allocated for adult social care contingent on the results of the Casey Review, which has only just begun, there are significant questions here.

There is also little clarity on public health spending in the Review, including drugs and alcohol services. Public health measures can be incredibly significant in reducing long-term trauma - which is so often either caused or exacerbated by inequity of access to information, resources and the structures people need to make lifestyle choices that give them the best chances of health and happiness.

Physical health crises also of course cause trauma for individuals and those who care about them, so the overall increase to NHS spending is very welcome - but what exactly that looks like remains to be seen.

Living standards and welfare (source: People’s Health Trust)

There is potential for a lot of good to come out of many of the Spending Review’s commitments to improve living standards and welfare.

Some of the allocation of £3.5billion for employment support and £1.2billion for training and upskilling will go towards the new Good Work for Young People’s Mental Health programme. Recognising a vicious spiral of unemployment and poor mental health as a key factor currently keeping 1 in 8 young people out of employment, education and training, this programme places Individual Placement and Support officers within local young people’s mental health charities in three cities. Without knowing how these officers will be working, we cannot be sure of what the outcome will be; but it is encouraging to see investment in collaborations with local charities, and acknowledgment that youth unemployment is not down to lack of will from young people. Meanwhile, the expansion of free school meals to every child in a state school living in a household in receipt of Universal Credit, will really boost young people’s mental and physical health and educational attainment, while easing pressures on families.

There are, however, a number of causes for concern.

There have been a lot of positive legislation changes recently requiring landlords to meet new minimum housing standards and faster action where they are not met, aiming to support people currently living in cold, damp and/or unsafe homes. But most of the onus for enforcement of these falls on local councils, which are already dangerously overstretched. The lack of enforcement funding to hold landlords appropriately to account is an oversight that could prevent a lot of people from having a stable base around which to build their lives.

Our gravest worry is around the planned changes to disability benefits - intended to support more disabled people into work, but in practice certain to push people facing health inequalities further into disadvantage and poverty. The introduction of ‘right to try’ - in other words, that people can try going back to work, and if they have to stop again within 6 months they can return to their previous benefit plan without reassessment - is long overdue, and will make a huge difference to people who want to work but otherwise would not be able to risk trying. But changes to Personal Independence Payment and disability component to Universal Credit thresholds will leave many without the funds they need to protect their health and wellbeing, and consequently contribute to society as fully as they are able - whether through paid work or in other equally valid ways. The changes will disproportionately impact people with mental health conditions and other conditions that are variable and unpredictable, as they are largely focused on the ‘daily living’ component that measures what someone can and cannot do on a day-to-day basis - with little room to express variance. We understand disability better than this, as a society, so it is hugely disappointing that these plans seem to be going ahead.

Social infrastructure (source: Women’s Budget Group)

Social infrastructure refers to that which directly facilitates social interactions, community engagement and quality of life - in contrast to physical infrastructure such as roads, homes and train lines. In terms of government spending, this usually comes down to ‘day-to-day’ costs such as health, social care, childcare and education.

The two work hand-in-hand, of course, both in terms of boosting the economy and in terms of enhancing wellbeing. Empowering people with the day-to-day support and stability they need to be able to contribute to society in the fullest way, is our greatest economic asset; as well as the best way to keep people in good physical and mental health, and to help people who have experienced trauma to create new lives and new memories for themselves on their own terms. Meanwhile, investing in more obviously economically lucrative things like housing and transport will, in the longer term, support social mobility, including helping people facing violence to find safety and independence.

The Review has kept the government’s ‘day-to-day’ spending at 1.2% in real terms, marking a lower priority than that given to physical infrastructure - but nevertheless, the Women’s Budget Group was encouraged by the Chancellor’s acknowledgement of the importance of “soft infrastructure” in building the economy, suggesting awareness of the importance of not losing sight of social infrastructure.

Homelessness (source: Museum of Homelessness)

From what we have observed, not having a safe place to call home (for whatever reason) is one of the most significant sources of trauma today - and the length of time for which people can be stuck in homelessness allows that trauma to become very deeply ingrained.

The Review has allocated £39 billion for “affordable and social housing” over the next decade. Of course, this displays encouraging acknowledgment of the scale of the problem and commitment to addressing it. Still, the homelessness sector as a whole has had mixed responses to this news, and again how effective this allocation will be depends on a lot of unknowns. if much of the funding goes to private developers, it will not lead to affordable housing.

To combat the housing crisis, the government needs to provide council housing at social rent. If much of this funding goes to private developers, this will not happen: private ‘affordable’ housing only has to be 80% of market rate, which still is not affordable to most experiencing homelessness. There are also huge questions around why the government is not investing in fitting up existing empty homes - of which there are already enough to house everyone currently homeless. This would be a much quicker and more cost effective way of addressing the housing crisis, and prevent people currently experiencing homelessness from suffering for longer than necessary.

It is also worth mentioning that, for this decade-long plan to come to fruition at all, future governments will have to stick to it - and there is no guarantee of that.

Refugees (source: Refugee Council)

The hostile environment for refugees is one of the leading causes of the sharp rise in homelessness in the UK - and huge disappointment has been voiced over the focus on deterrence rather than protection of refugees in the Spending Review. Millions is to be spent on drones tracking the English Channel for small boat crossings, but no long-term commitment has been made to resettlement, tackling the huge backlog of asylum cases waiting for an initial decision, giving unaccompanied children the support they need, or helping refugees to move smoothly into mainstream public services. Ultimately, these things would make the system more efficient and cost-effective - as well, of course, as less traumatising.

Foreign aid (source: Women’s Budget Group)

On a similar vein, the Spending Review cutting foreign aid to fund defence has been called short-sighted and disappointing. As the Women’s Budget Group expressed, aid is itself an important defence against conflict - which is exacerbated by poverty, inequality and lack of resources. In particular, cutting foreign aid will disproportionately impact women and girls, given the current international crisis of women’s and girls’ rights. 

Equality on the whole (source: Women’s Budget Group)

Further to this, the Women’s Budget Group identified that although every government department including the Treasury is subject to the Public Sector Equality Duty, the Treasury has not published any detailed equality impact assessments of the Spending Review process or final allocations. As a result, beyond departments, it is difficult for us to understand which societal groups can expect to gain or lose from the Review.

Criminal justice (sources: Working Chance, Bounce Back and Women in Prison)

Several sources here, as the feeling is so different, partly depending on what aspect of the criminal justice system is being discussed. Satisfaction has been expressed about the focus on early intervention and crime reduction through additional funding for probation services, courts, and alternatives to custody, and recognising housing, support and employment as vital to successful rehabilitation.

This acknowledgment, though, is dwarfed by the amount of investment in delivering additional prison places. Women in Prison went so far as to say that the Spending Review is “funding failure” - as the government’s official strategy states an intention to reduce the women’s prison population. Working Chance has additionally expressed disappointment at the lack of commitment to gender-specific support and wrap-around support services. The Spending Review States a commitment to providing funding necessary to deliver on the Independent Sentencing Review’s recommendations; but without specific reference to where additional funding for women's centres will come from, it is hard to tell how this will be honoured.

Women in the criminal justice system predominantly receive short sentences. Serving these in community-based ways through the support of women's centres prevents unnecessary disruption to factors such as family ties and housing security, but can also address the root causes of offending such as poverty, homelessness, childhood trauma, mental ill health, substance abuse, and domestic and sexual abuse. Prison, on the other hand, can be traumatising, retraumatising, and cause disruption or destruction to what little social infrastructure people have. Community-based approaches cut reoffending rates and are more cost-effective than prison, as well as (and because of) improving outcomes for the individuals. Whether and how the government will honour their implicit agreement to sustain and improve them remains to be seen.

The arts (source: Campaign for the Arts)

As mentioned at the beginning of this post, the arts has lost out more than any of the other areas we have mentioned in this Spending Review. This is the second successive spending review at which the Chancellor has implemented real-terms cuts to DCMS while increasing overall spending - which is unprecedented since Spending Reviews were introduced in 1998, and demonstrates a real lack of commitment to the arts and culture from our government.

DCMS directly funds 15 national museums and galleries, Historic England and the British Library, and the British Film Institute and Arts Council England. The cuts announced will leave it with well over a third less to spend per citizen on Culture, Media and Sport in real terms. We do not yet know how DCMS will reallocate its new smaller budget and it may be that the cuts to these arts institutions will not be as drastic as the cuts to DCMS as a whole; so, we wait in anticipation.

The 0.8% growth in the Department for Education (DfE)’s overall budget is somewhat promising in the face of rapid decline in arts education, for example the end of the DfE’s funding partnerships for several cultural education programmes in 2025-26 that was announced in February. However, this growth also has to accommodate the expansion of free school meals and rising demand for special educational needs provision, which will be considerable and may not leave much room for unexpressed priorities. No mention was made at all of addressing the funding crisis in Higher Education, in which several arts courses and even whole departments are facing huge cuts or closure. We are pleased to see mention of the government’s plan to invest £132.5million from dormant bank accounts into school libraries and opportunities for young people from disadvantaged areas to take part in music, sport and drama; but this is a very small plaster for a very big problem.

Local authorities are the biggest public funders of culture, heritage and libraries in England, and grants to local councils will grow by 1.1% - however, again, councils’ support for the arts is increasingly being jeopardised by increasing pressures and demand on local services, with a historic number teetering on the edge of bankruptcy.

Deprioritising arts spending may seem sensible with so many other pressures on people’s wellbeing, health and quality of life. But the arts are our way of understanding the world around us: validation in seeing our perspectives expressed by others, education in being exposed viscerally to others’ perspectives, solidarity and social cohesion in sharing experiences. Cutting public spending on the arts doesn’t stop them from happening, but does severely limit who can make and watch them, which limits what stories get told, how many perspectives they are told from, and who gets to see them. Again, welfare and disability cuts will have a huge impact on who gets to lead on how stories are told and learned from - as brought to light recently by Touretteshero co-founder Jess Thom's announcement that a 61% cut to her Access to Work support package resulting from the government's enormous cuts to the programme as a whole, has led her to have to stop working.

A society that doesn’t seek to support all people to make themselves seen and heard, and to use creative, joyful, reflective, powerful and vibrant media to encourage people to think and feel beyond their own spheres, pushes those already facing exclusion and inequity into invisibility and silence. This will further impact employment and social integration, mental and physical health, wellbeing and social cohesion - with knock-on effects for the economy and for our increasing traumatised community of survivors.

It must not be allowed to happen - and, despite the Spending Review, there are ways in which arts by and for everyone can still exist. Especially in our line of supporting survivors of traumatic experiences, we will be pushing for the health sector to look further out to grassroots charities and arts collectives like ours to deliver the kind of work that has been proven time and time again to work wonders in improving people’s health and making or ingraining public health improvements. When there is more clarity on adult social care spending, we can also hope that the social care sector will look to the arts for ways to make their work person-centred, inspiring and empowering.

Beyond that, it is clear that trusts and foundations, philanthropy and individual donations will be crucial in keeping the socially engaged arts sector alive, and delivering the outcomes that support, platform, entertain, educate and unite people in every corner of our society.

In conclusion:

Our eyes, hearts and minds are open to the possibility of real change in many areas. But our ears are to the ground for clarity on many crucial details, and we are primed to take whatever action we can to protect survivor’s rights to autonomous expression, opportunity, integration, health, happiness and post-traumatic growth on our own terms.