On 28 August 2026, the NHS Alliance (a body representing NHS leaders) issued a warning: spending on ADHD and autism assessments and treatment is “running out of control.” One care board saw monthly costs jump from £146,000 to £1.5 million. In Cheshire and Merseyside, adult ADHD spending rose from £11 million to a projected £51 million this financial year. Prices for similar assessments now range from £300 to £3,000. The Alliance wants a national mandatory price and a standardised service specification across all NHS-funded providers.
Headlines quickly framed this as ADHD demand spinning out of control. That framing is backwards.
The Real Story Is Not “Too Many Diagnoses”
The surge did not appear from nowhere. For decades the system treated ADHD as a childhood behavioural issue, mostly in boys who couldn’t sit still in classrooms. Adults, especially women, were largely invisible. Awareness grew. Stigma dropped. People who had always lived with these traits finally recognised themselves and sought assessment. Waiting lists ballooned because the system never built capacity for the actual size of the population that had been there all along.
What the NHS Alliance is describing is not people suddenly inventing ADHD. It is a rigid, under-resourced system colliding with demand it refused to prepare for. When hundreds of thousands finally ask for recognition, the system calls the bill “out of control.” The minds were never the problem. The planning was.
Who Is Actually Out of Control?
A system that:
- Left people waiting years for assessment
- Allowed prices to swing wildly between £300 and £3,000 for the same service
- Relied on a patchwork of private providers because its own capacity was never expanded
- Now frets that meeting real need might displace other budgets
is not a system managing a crisis of overdiagnosis. It is a system that failed to treat different minds as part of normal human variation and is now shocked by the cost of catching up.
The “Right to Choose” policy let patients go private when NHS waits became intolerable. The NHS then paid the bill. That is not ADHD people gaming the system. That is people using the only route left open after the public system failed them.
Standardisation Is Not the Same as Gatekeeping
A national tariff and clearer service standards could reduce the chaos of wildly different prices and quality. Done honestly, that could help. Done as a way to quietly restrict access or reframe genuine need as excess demand, it becomes another tool for control.
The Independent Review into mental health conditions, ADHD and autism is supposed to examine what is driving the surge. That review will matter. If it starts from the assumption that rising numbers equal overdiagnosis, it will miss the point. The more accurate reading is that decades of under-recognition are finally becoming visible — and a system built around conformity is struggling to absorb the reality of different operating systems.
The Bottom Line
ADHD minds are not out of control. A system that pathologises difference, underfunds recognition for years, then panics when people finally demand to be seen is what is out of control.
Costs are rising because unmet need is large. The honest response is not to treat the people seeking assessment as the problem. It is to redesign the structures that treated their minds as optional, inconvenient, or expensive to acknowledge in the first place.
At ADHD Corner we hold a different starting point: these minds are not a disorder to be contained. They are an older order of thinking that the current system was never designed to hold. When that system cracks under the weight of its own design failure, the language of “out of control” gets pointed at the wrong target.
The bill is high. The failure that produced it is older still.
