A £5bn emergency response fund to help the National Health Service cope with coronavirus was announced in the Budget, and the chancellor promised “whatever extra resources” might be needed to cope with the outbreak.
In a fiscal statement dominated by the unfolding health crisis, Rishi Sunak said: “Whether it’s research for a vaccine, recruiting thousands of returning staff, or supporting our brilliant doctors and nurses, whether it’s millions of pounds or billions of pounds, whatever it needs, whatever it costs, we stand behind our NHS.”
The £5bn, to cover not simply health but social care and other public services, was only a first step, he suggested, vowing to go “further if necessary”. The unusually open-ended pledge, of a kind that chancellors would normally avoid, reflects concern that a health service already under huge pressure will be unable to cope if it faces a flood of critically ill people in the coming weeks.
Keen to keep the fealty of voters who switched from Labour to back the Conservatives for the first time in last December’s general election, prime minister Boris Johnson has named the NHS as his priority.
The Budget confirmed plans set out in the Tories’ general election manifesto last year, promising more than £6bn of new funding over the parliament to fulfil a range of Conservative campaign pledges, including 50,000 more nurses, 50m more general practitioner appointments and a promise to “make progress on” 40 new hospital projects.
More than £100m of this hospital investment will be allocated in 2020-21, reflecting the government’s determination to be seen to be making measurable progress even in the early part of the parliament on fulfilling its promises to voters.
Mr Sunak also announced a boost to NHS capital spending of £683m in the next financial year. This would allow hospitals and other key services “to continue to invest in important capital projects such as estate refurbishments and building maintenance”, the Treasury said.
However, campaigners protested at “the elephant in the room” — the failure to earmark additional money for social care as local authorities struggled with the twin pressures of budget cuts and an ageing population.
John Appleby, chief economist at the Nuffield Trust think-tank, suggested that the urgent need for people to be supported at home if they fell ill with the virus had shone a light on the failure to overhaul social care.
“We are about to rely on these threadbare services to keep thousands of vulnerable patients out of hospital — and yet we still will not give them the funding and reform they have desperately needed for years. Coronavirus may serve as a reminder that inaction has consequences,” Prof Appleby added.
While the extra money pledged in the Conservative manifesto, and “modest” extra NHS capital spending, was good news, the NHS’s ability to respond to the coronavirus outbreak was being hampered by “a decade of underfunding and understaffing”, Prof Appleby warned.
Mr Sunak linked the NHS funding to two money-raising measures. The first was a clampdown on “aggressive tax avoidance, evasion and non-compliance”, including extra funding for HM Revenue & Customs to secure £4.4bn of additional revenue.
Secondly, the immigration health surcharge, paid by new arrivals to the UK, would be increased by more than 50 per cent, from £400 to £624, he said. It is expected to raise about £1.5bn by 2024-25.
Siva Anandaciva, chief analyst at The King’s Fund think-tank, said chronic workforce shortages remained the single biggest issue currently facing the NHS and social care. The Budget was “light on detail of how it would boost recruitment and retention, and support under-pressure staff”, he said. Publication of a long-term NHS people plan “has been repeatedly delayed and held back to allow for today’s Budget commitments, so it is now essential to get this published as soon as possible”.
Mr Anandaciva pointed to the government’s manifesto commitment to extend healthy life expectancy and narrow health inequalities by 2035 — a pledge that has been seen as part of Mr Johnson’s much-touted “levelling-up” agenda.
Yet local directors of public health are still waiting to find out how much they will have to spend from next month. “Following on from years of cuts to public health budgets, this begs the question of how seriously the government takes its commitment to improving people’s health”, Mr Anandaciva warned.
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