Delivering his autumn 2018 budget in Parliament yesterday, the Chancellor, Philip Hammond, described his plans as a “Budget for Britain’s future” and reiterated his claim of last week that the era of austerity is over.
Reception to the budget has been mixed, with Labour leader Jeremy Corbyn calling it a “broken promise budget” and GMB Union saying it is “more trick than treat,” enraged that more money is allocated to fixing potholes than to education.
The big headline for the NHS of course had already been leaked back in June – the confirmation of an £84bn, five-year deal for the NHS, which, the Chancellor’s Budget document claims, constitutes an: “historic, £20.5bn real terms increase for the NHS in full over the next five years.”
The plan to deliver the attached strings to this new funding - around the ten-year plan, service reform and waste reduction to ensure the tax payer gets value for that money - would, he said be published shortly. However, he confirmed a number of measures for mental health that have been broadly welcomed.
The ten-year plan will include a new mental health crisis service, which will mean comprehensive mental health support to be available in every major A&E. Children’s and young people’s crisis teams will be in every part of the country, there will be more mental health ambulances, more ‘safe havens’ in the community and a 24-hour mental health crisis hotline.
This £2bn funding increase for the mental health sector has been welcomed. Sean Duggan, Chief Executive of the Mental Health Network, which is part of the NHS Confederation, said: “The prospect of an additional £2 billion of funding for mental health by 2023/24 is a welcome step on the journey towards true parity of esteem.
“The scale of the challenge the sector faces cannot be underestimated. Last week’s report from the IPPR concludes that a 5% annual increase in the mental health budget is absolutely necessary in order to achieve true parity with physical health.
“It is positive to see that specialist crisis teams for children and younger people will be set up in every part of the country as we know how important it is to address mental illness as early as possible. However, we must keep our eyes on the immediate needs of our core inpatient and community mental health services, and we must also remember that social care, capital budgets and public health will need additional funding.”
GP, Dr Zain Sikafi, CEO and co-founder of the Mynurva platform that provides live video therapy and counselling sessions also welcomes the funding as a “step in the right direction,” but he adds that £2bn doesn’t go far enough.
“Just recently depression moved up to take second place on the GP list of common illnesses, overtaking obesity. It’s become clear that the mental health crisis warrants a significant commitment if we are to tackle the problem and improve services across the country. And yet still only a fraction of total NHS spending will be directed towards mental health, undermining the Government’s ambition to put mental health on equal footing with physical health.
“With mental health having long taken the backseat, there is a lot of catching up to do if we are to improve the provision of these vital services. The overwhelming feeling from the Budget is that while there has been some positive progress, much more needs to be done. And regrettably, the Chancellor’s speech failed to disclose any new details about the policy reforms that will introduced in support of mental health services – merely reiterating what had already been announced in the lead up to the Budget.”
UNISON’s Head of Health Sara Gorton agrees that it isn’t enough. “There’s no doubt more money is needed. But the government must listen to those quitting mental health jobs every day and do more to attract and hold onto highly skilled staff.
"More must be done to make mental health services safer and kinder places to work – for the benefit of patients and staff.”
She adds: “The amount announced today is likely to be swallowed by deficits, which effectively means standstill funding at a time when all of us need the NHS more.”
Additional funding was also announced for Social Care. £240m for winter pressures was announced earlier in the month; the Chancellor yesterday promised a further £650m of grant funding for English Authorities for 2019-20, an additional £45m for the Disabled Facilities Grant in England in 2018-19 and a further £84m to be invested over the next five years, which would help councils to improve services for older people, those with disabilities and children in care. The awaited Green Paper on the future of Social Care will set out more choices and challenges for the future sustainability of Social Care.
Labour’s Shadow Cabinet Minister for Social Care, Barbara Keeley, described these Social Care measures as a: “short-term sticking plaster to stave off catastrophic collapse in social care, not the long-term funding the social care system desperately needs.”
There were mixed messages for the future of private-public sector collaboration. The Chancellor stressed he remained committed to the use of such partnerships for financing public infrastructure where they represent value for money for the taxpayer and where they genuinely transfer risk to the private sector. However, announcing his decision to scrap PFI and PF2 schemes for any future projects, he said there is “compelling evidence” that the Private Finance Initiative does not provide value for money or transfer the risk.
Existing contracts will be honoured, but, the Budget document says: “the days of the public sector being a pushover must end.” A centre of excellence will be established to actively manage existing PFI contracts in the best interests of the taxpayer and this will begin in the health sector.
A report earlier this month from the Centre for Health and the Public Interest (CHPI) claimed that excess interest and inflation payments on PFI debts have cost Trusts £1.3bn over the year years from 2014/15 to 216/17. In 2016/17 alone these excess PFI interest and inflation costs would have reduced the Trusts’ overall deficit by 30% if they had been paid centrally instead.
PFI has been used to build 127 NHS hospitals and facilities and the report stated that over £831m has been extracted from the NHS in the form of PFI profits.
MPs from all parties will debate the Budget in Parliament later today.
