Ms Reeves promised 'more appointments, more doctors, more scanners' (Image: Getty)
A record ￡29million cash boost for the NHS is no guarantee that waiting times targets will be hit, health leaders warned within minutes of the Chancellor finishing her speech. Rachel Reeves promised “more appointments, more doctors, more scanners” as she announced a 3% increase in real-terms, day-to-day spending for the health service.
She said the investment was needed to support the Government’s upcoming 10-year health plan, “back the doctors and nurses we rely on, and to make sure the NHS is there whenever we need it”. Sector leaders welcomed the funds but warned that much of the cash would be soaked up by pay rises and rising medicine costs. Matthew Taylor, chief executive of the NHS Confederation, said: “Health leaders recognise that the NHS is being prioritised for investment over other parts of the public sector.
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“The funding boost is welcome given the precarious state of public finances and will help the NHS to cope with rising demand from an ageing population, often with multiple or more complex physical and mental health conditions.
“But difficult decisions will still need to be made as this additional ￡29 billion won’t be enough to cover the increasing cost of new treatments, with staff pay likely to account for a large proportion of it. So on its own, this won’t guarantee that waiting time targets are met.”
The Government has pledged to hit a target that 92% of patients should start routine treatment within 18 weeks, a goal that has not been met for a decade.
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However, it was reported this week that internal Department of Health modelling shows the NHS is on course to only reach a level of 80% by the end of this parliament.
Mr Taylor added that the “flat settlement” left a major shortfall in capital funding, which is needed to repair and rebuild crumbling facilities and upgrade equipment. There is currently an almost ￡14 billion maintenance backlog bill to repair NHS hospitals and buildings.
Sarah Woolnough, chief executive of The King’s Fund, said the upcoming 10-year health plan would hopefully set out details of how the money can be “translated into better, more efficient services”.
She added: “The Chancellor said she wants the public to have 'an NHS there when they need it'. It is hard to see how all the things she mentions — faster ambulance times, more GP appointments and adequate mental health services and more — can be met on this settlement alone.
“Particularly when large parts of this additional funding will be absorbed by existing rising costs, such as the higher cost of medicines, which are currently being negotiated, and covering staff pay deals.”
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Government documents accompanying the spending review show that, on average, the Department of Health and Social Care (DHSC) budget will increase by ￡2.3 billion in real terms by 2029-30, compared with 2023-24.
The figures suggest department spending will rise 2.8%, though this is less than the average 3.6% in recent years.
The Government also expects the NHS to deliver 2% productivity growth each year, “unlocking ￡17 billion savings over three years” to reinvest back into the NHS to improve patient care.
Ms Reeves also came under fire for failing to allocate significant funding to improve social care. Dennis Reed, director of over-60s campaign group Silver Voices, said the cash allocated to the NHS “will not be cost-effective because adult social care has been sold out yet again”.
He added: “The independent Health Foundation considers that just to stand still an extra ￡3.4 billion will be required for social care by 2028/29, and to improve access as well would require ￡6.4 billion.
“We see no extra cash for social care in this review and the underfunding of local government makes further social care cuts inevitable.
“This blinkered bias towards hospitals will be counterproductive, as a lack of community support means more pressure on hospital beds and accident and emergency departments.”
NHS Providers chief executive Daniel Elkeles said: “Once again, social care — which is in desperate need of attention — hasn't been given the focus it needs.
“Leaving patients and the public without appropriate care is a significant blocker on progress for the NHS.”
Speaking at NHS England and the NHS Confederation’s joint ConfedExpo conference in Manchester yesterday (WEDS), NHS chief executive Sir Jim Mackey told colleagues the service would always “want more money”.
But he described the amount allocated to it in the Spending Review as “what the country can afford to give us”.
Sir Jim said: “The NHS has done really well relative to other parts of the public service, but we all know it’s never enough because of the scale of advancement, all the ambition, all the things we want to do, the day-to-day cost pressures.
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“We’re always going to be in a world where we want more money, but I think everyone’s starting to accept and understand that we’ve got what the country can afford to give us, and we really need to get better value for that money.
“It is broadly the equivalent of the GDP of Portugal, so it’s a huge amount of money by any standards.
“The Government has done us a really good turn compared to other parts of the public service, but it’s not going to allow us all to just take our feet off the pedal.”
Sir Jim, who was speaking a couple of hours before Ms Reeves took to her feet in the Commons, added: "Social care in local authorities won't do brilliantly in the Spending Review, and then we have the review of social care, so we will be left with what we can do as much as we can within our gift."
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The NHS boss, who took over the role from Amanda Pritchard in April, said the organisation had recently faced “turbulent times” including the “extreme moment” when Sir Keir Starmer announced the abolition of NHS England, the quango responsible for planning and commissioning health services.
He added that the NHS still has “an awful lot of difficult things to do”, with further changes set to be outlined in the 10-year plan.
Sir Jim said this would include a “focus on quality” because “we have lost our way a little bit on quality coming out of Covid. You will hopefully see that, read [the plan] and think, thank God for that.”
NHS progress will take time, says SIVA ANANDACIVA
The NHS has faced financial pressure for more than a decade, and the result is that we are waiting longer for the care that we need.
To cope with these financial pressures, local NHS services are having to be diluted or scaled back — with cuts to services that transport patients to and from hospital, holding down the number of nurses and doctors that can be employed, and reducing investments in the services that give children the best start in life, like health visiting and school nurses.
The key figure today is that health spending will increase by 2.8% on average in real terms over this parliament.
While this will mean billions more spent on the NHS, this amount is still lower than the 3.6% average increases the NHS typically receives over the long-run.
And because some of this funding will be spent on covering pay deals for NHS staff and higher costs of medicine, it will still take time before waits for hospital care and GP appointments rapidly fall.
The Chancellor today said this government wants the public to have ‘an NHS that is there when they need it’. This is part of the government’s mission to fix a ‘broken NHS’ and transform the health of the nation, through the publication of their upcoming 10 year plan for health.
That plan will be based around three shifts, which are the right ones for our health service to make: delivering more care closer to people’s homes, investing in digital technologies, and bolstering preventative services.
But until that plan is published, it will be hard to see how today’s funding will be translated into better care for patients and the public.
- Siva Anandaciva is director of policy, events and partnerships at The King’s Fund
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