Chancellor Philip Hammond’s NHS commitments in the Budget were welcome, but he did not go nearly far enoughby Anita Charlesworth / November 24, 2017 / Leave a comment
The Chancellor’s nickname is Spreadsheet Phil—he is not seen as a risk-taker. But much of the pre-Budget commentary stressed that Wednesday could not be a “steady as she goes” affair. The politics and economics of our age demand action.
For many people one of the big tests for this Budget was how the Chancellor would address the toll that seven years of austerity has taken on our major public services. Would he be bold, break from the tight constraints of the spending limits imposed by his predecessor and increase funding to them?
One of the biggest single areas of public spending is the NHS. Just two weeks ago, the head of NHS England, Simon Stevens starkly reminded the chancellor that ignoring the pressures facing the health service would be a very risky strategy. This is true both for the health service itself and politically, with 90 MPs signing a letter on the NHS last week emphasising the need for a cash injection—including 33 Conservatives.
In a fairly unprecedented intervention, Stevens claimed that without extra funding, far from growing, the number of nurses and other frontline staff, hospitals, community health services and GPs were more likely to be retrenching. That it would be increasingly hard to expand mental health services or improve cancer care. And crucially, that the NHS waiting list would grow to five million people by 2021, reversing the progress that has seen the wait for an NHS operation cut from over 18 months to under 18 weeks.
Stevens threw down the gauntlet to the chancellor, saying it was not realistic to expect the NHS to continue to bridge the gap between sluggish funding growth and rising demand through efficiency targets. Stevens was clear that if the funding didn’t change, the “offer” from the NHS would have to; the government would have to legally abolish the national waiting times guarantee.
“We can no longer avoid the difficult debate about what it is possible to deliver for patients with the money available”—Malcolm Grant, NHS England chair
Philip Hammond decided that sticking to his predecessor’s NHS spending plans was a risk not worth taking. In this Budget the NHS was the clear winner, receiving an immediate cash injection of £350 million for winter pressures plus extra capital investment. Next year the budget in England will be…