New Chancellor, Sajid Javid’s first Spending Review has been roundly criticised as failing to solve the health and social care crisis currently facing the country.
In his announcement yesterday, Javid promised increased spending on priority areas of schools, police and health.
But he said the Government would stick to the current borrowing rules, limiting the scope for extensive spending increases.
Today’s funding is not enough to reverse the cuts of recent years, and will mean that vital treatments such as sexual health, smoking cessation and drug treatment services are not available to many of the people who need them
In terms of healthcare, he increased NHS spending by £6.2billion next year and revealed a £210m fund for frontline NHS staff.
The Treasury will also invest more in training and professional development for doctors and nurses; and Javid reiterated the earlier announcement of a £2billion capital funding boost – starting with the upgrade of 20 hospitals this year, and £250m for new artificial intelligence (AI) technologies.
Described by Labour as ‘a one-off pre-election panic-driven stunt budget’, Javid said the Government could afford to spend more on its priorities after a decade of cuts.
Writing in the Daily Telegraph, he added: “Thanks to the hard work of the British people over the last decade, we can afford to spend more on the people's priorities - without breaking the rules around what the Government should spend - and we'll do that in a few key areas like schools, hospitals and police.
"But at the same time, it's vital that we continue to live within our means as a country.
"We don't believe in just throwing money at a problem. And, especially at a time when the global economy is slowing; it's important that we don't let our public finances get out of control."
And he said the departments for which he was funding increases were ‘lifelines of opportunity’.
But what does this all mean for NHS and the wider health and social care sectors?
Sally Warren of health think tank The King’s Fund said: “Today’s funding is not enough to reverse the cuts of recent years, and will mean that vital treatments such as sexual health, smoking cessation and drug treatment services are not available to many of the people who need them.”
The funding at best stops the current problems getting worse, but doesn’t undo the years of underinvestment, and will do little to overcome the workforce shortages endemic in health and care
She added: “Health Education England will receive 3.4% real-terms growth in funding – this broadly paying for the announcement this week of £1,000 for nurses and midwives working in the NHS for continuing professional development.
“This is probably as much as could be expected, but doesn’t give the certainty and funding for the expansion in medical and nurse training places desperately needed to begin to tackle the high levels of vacancies in health and care services.
“It’s hard to see how this one-year settlement will provide the certainty needed to develop the final NHS People Pla, which is expected by the end of the year.”
And she described as ‘disappointing’ the least-generous aspect of the health and care settlement – the Public Health Grant, the part of the system most focused on prevention, and one of the Secretary of State’s top priorities.
“The Public Health Grant will remain ringfenced for at least next year (good), and will receive a small, unspecified increase – less than any other part of health and care service delivery,” she explained.
“The evidence base for action on prevention is clear, so this decision is short-sighted and out of step with the ambition for the NHS long-term plan to deliver a step change in action to prevent or delay ill health.
“Today’s funding is not enough to reverse the cuts of recent years. This will take a toll on people’s health and bring knock-on costs for the wider health and care system.”
But, perhaps most concerning, according to Warren, is adult social care.
“Working out what the settlement will mean for this area is a bit tricky,” she said.
“There are lots of different pots of money to try to make sense of.
“All the various different grants which were due to end in March 2020 will be rolled forward – which is good news.
The Chancellor’s pledge of an additional £1.5billion for adult and children’s social care over the next year falls woefully short of the estimated £3billion needed to keep a financially-sustainable footing for the adult social care sector alone
“On top of that foundation emerge a few different sources of additional funds.
“The NHS’s contribution to social care through the Better Care Fund increases by 3.4% in real terms – in line with the overall settlement for the NHS Long-Term Plan.
“And a new grant of £1billion will go direct to local authorities for social care for all ages.
“We can’t guarantee how much of that will go to adult social care, rather than children’s services, as that will be a local decision; but with a similar grant this year just over half went to adult services, so assuming £500m will go to adult social care seems reasonable.
“Councils are also given permission to use a 2% council tax precept for adult social care, which would raise another £500m, assuming all councils use it.
“So, overall, between a combination of NHS contribution, permission for more locally-raised funds, and new grants from central government, it looks like growth of about £1billion for adult social care.
“That is to be welcomed – but it will only just meet what most in the sector said would be the bare minimum in 2020/21 to keep to system going.
“It’s enough to meet demographic demand pressures, but it’s not going to be enough to increase quality, meet unmet needs, or give much stability to providers and the hugely-under-valued social care workforce.”
In conclusion, he said: “To be fair to the teams in Whitehall, who worked flat out this summer to deliver a Spending Round at breakneck speed; this is a decent outcome.
“A number of critical parts of the health and care system will receive the investment levels of the NHS Long-Term Plan for one year.
“Though, before we get too carried away, it’s worth remembering that 3.4% is less than the long-term historical growth and less than is needed to both stabilise and transform services.
“The funding at best stops the current problems getting worse, but doesn’t undo the years of underinvestment, and will do little to overcome the workforce shortages endemic in health and care.
“In relation to the NHS, we have previously said funding increases are not enough to meet standards of care and transform services. And today’s numbers don’t change that.
“We need a proper multi-year financial settlement for all of health and care to really have confidence that the sector as a whole can plan for and deliver a health and care system fit for the future.”
By incentivising local authorities and providers to invest in the long-term future of their services, we believe we can realise the untapped potential of assistive technologies to offer more-meaningful support to adults with learning disabilities
Also commenting on the announcement, David Morris, public sector health leader at professional services network, PwC, told BBH: “Additional cash for healthcare is undoubtedly welcome, but, with the NHS nationally facing a £4-5billion deficit, and more than 200 individual trusts overspent; this award and, indeed, money alone will not solve the crisis.
“As the population continues to age, and demand continues to rise, it is vital that the health and social care system accelerates the pace of change to ensure improved outcomes, that available resources are optimised, and patients are empowered.”
And Billy Davis of learning disabilities charity, Hft, adds: “The Chancellor’s pledge of an additional £1.5billion for adult and children’s social care over the next year falls woefully short of the estimated £3billion needed to keep a financially-sustainable footing for the adult social care sector alone. /p>
“With the Prime Minister announcing Theresa May’s planned green paper on social care will be replaced by his own white paper, the publication of which has been delayed, this additional funding feels like a short-term solution to an ongoing problem.
“And we believe that the time for short-term solutions is over.
“This is why Hft, in partnership with Tunstall, is calling for a Sector Deal for the learning disability sector.
“By incentivising local authorities and providers to invest in the long-term future of their services, we believe we can realise the untapped potential of assistive technologies to offer more-meaningful support to adults with learning disabilities.
“This will not only stimulate innovation, but also help reduce local authority spending in a way that does not compromise the financial stability of the sector, or the quality of support that it is able to provide.”
There is no easy fix, but it is high time the Government acknowledged how integral specialist housing is in solving the social care crisis
Adult social care provider, Audley Group, also fears the cash is being ploughed into an ‘already-broken system’ and has accused the Government of ‘firefighting’.
Nick Sanderson, chief executive, said: “Our leaders have yet again failed to consider social care in the round and continue to firefight without tackling the root of the problem.
“There is no easy fix, but it is high time the Government acknowledged how integral specialist housing is in solving the social care crisis.
“We need more specialist retirement housing, and quickly, as older people living in appropriate accommodation are less of a burden on the state.
“Furthermore, such a move would help clear the housing market bottleneck as stock at the top end is freed up. It’s a win-win for the Government.”
