The Spring budget was more notable for what it did not deliver for the NHS than what it did. There was no commitment to a long-term capital plan, no word on investment to tackle the workforce shortage or a definite date for the long-term workforce plan, no hint of a settlement for industrial action, no help for reducing NHS waiting lists (one of the PM’s five New Year pledges) and no mention of the New Hospitals Programme. In fact, apart from the changes to pension tax charges aimed at keeping senior clinicians in work for longer, the NHS didn’t feature at all, other than a repeated promise that the long-term workforce plan, promised in the Autumn Statement, would “shortly” be published.
Responding to the budget, Matthew Taylor, Chief Executive of the NHS Confederation said: The reality is that this budget leaves more questions than it answers when it comes to the NHS.”
He welcomed the news on pension reform, the extension of the energy price cap and the increase to the childcare allowance, which collectively should help to keep more NHS workers in their posts whilst preventing further worsening of health outcomes for the poorest people across the country,
However, he added that significant concerns remain over the staffing crisis, funding of any future pay awards and addressing backlog maintenance.
“We are facing a staffing crisis in the NHS and this budget does not provide any further clarity on how the government is going to address it.
“We are just two weeks out from the start of the new financial year but don’t yet know the impact of any pay award on the NHS’ already constrained budget. The government and unions remain in talks, and we wait to see if a deal can be reached. The NHS currently has funding for a 3.5% increase next year, but with rumours of a potential pay award of 5% or above, this could leave the NHS with a budget hole of anything up to £2 billion. We are clear that this cannot be funded from within existing budgets as it would almost certainly result in cutbacks to patient care elsewhere.
“There is also nothing in the budget to help tackle the estates maintenance backlog; repairs are estimated to cost £10.2bn which if left unaddressed will undermine efforts to reduce waiting lists. There is still little clarity over social care funding, and while a small amount of funding for suicide prevention charities is welcome, there is little else for mental health services.
“Every NHS leader in the country was also hoping for the publication of the long-awaited workforce plan. The government should be credited for committing to publish the plan, but with 124,000 vacancies this is now long overdue. We need to see that plan shortly and it needs to be fully funded. Without this, the NHS will be in permanent crisis management mode, and we need to offer NHS staff hope that this long-standing issue will be addressed.”
In a blog published before the Chancellor, Jeremy Hunt, delivered his budget, Julian Hartley, Chief Executive of NHS Providers warned: “If we fail to tackle the vast workforce shortages urgently, the future of the health service will be at risk.”
He added: “When he [the Chancellor] delivers the Spring Budget in the coming days, he and the government must honour the commitment in the Autumn Statement to deliver a long-term NHS workforce plan. And deliver they must.”
But deliver they didn’t. Julian Hartley described this as “disappointing,” and warned: "We will hold him to his word on publishing the plan shortly, in the expectation that it will be appropriately detailed, with staff numbers, costs and funding to match. There must be no more delays.
"This will be key to getting a grip of the severe workforce shortages and unsustainable workloads we see in the NHS alongside recruiting and retaining the staff we desperately need to meet ever-growing demand.”
On the lack of an announcement concerning the New Hospitals Programme (NHP), he said: "We know from the sheer number of applications from Trusts to join the NHP and the staggering £10.75bn maintenance backlog across the NHS, that there is an undeniable need to provide Trusts and systems with major funding for capital projects.
"It is vital that the government urgently makes decisions about the future of the NHP, the growing maintenance backlog and the need for funding to replace RAAC (reinforced autoclaved aerated concrete) planks."
