This week saw a turn in the long running pre-election political arms race over NHS funding, as Chancellor George Osborne announced a £2 billion a year cash injection and a one off £1.1 billion payment to improve GP services. The additional funding was again described by Osborne as a ‘down payment’ on the ‘Five Year Forward View’, an NHS plan set out by Simon Stevens the NHS England CEO in October, asking the government to stump up a further £8 billion a year by 2020 to keep the system afloat.
The additional funding was gratefully received by Stevens’, with his official statement claiming that the Government had listened to his pleas and ‘responded with the funding we need for next year to sustain frontline NHS services and kick-start transformation’. He didn’t, however, make any mention of the fact that only £1.7 billion will be given to NHS England, with the remaining cash being shared amongst the devolved administrations. This was re-confirmed in today’s Autumn Statement speech.
Labour was quick off the mark to challenge the source of the ‘new’ funding, uncovering that £0.7 billion already sat within the NHS budget, and is simply being re-distributed to front line services. Ed Balls instead claimed that Labour would be willing to further increase their NHS spending commitment above and beyond that of the Conservative’s.
With the headlines dominated by the Autumn Statement projections, people may have missed Jeremy Hunt’s follow up speech on Monday in which he also announced that the new funds will only be made available to those hospitals that are prepared to produce clear plans as to how they will become more efficient, sustainable, and increasingly digital. He also stated that an additional £200 million would be made available to pilot the new models of care set out in the ‘Five Year Forward View’.
It is clear that the NHS will continue to feature heavily in the election campaign, as both parties gear up for one of the most tightly contested general elections of our time. Labour have positioned themselves to fight this election primarily on the NHS versus the Conservatives on the economy. The increased funding pledges, therefore, are not politically surprising as Osborne’s play to neutralise Labour’s polling lead on the NHS and divert voter attention back to the ‘long term plan’ continues.
With all parties pledging to increase funding, how this money will be spent comes into sharp focus. No matter how much is committed, the long term challenge of generating further huge efficiency savings by 2020 remains. Many policy experts agree that the structural change required to deliver a 21st century health service will require some doubling up of health spending in the short term as organisations undergo change. If directed here these funds will have little short term impact but could maintain a sustainable health service in the longer term. But with the political pressure of an election, how much will be used to shore up failing Trusts, keep waiting lists down and see out the winter?
It is unsurprising that little detail was discussed during Osborne’s speech, and a land grab for pots of this money is likely to ensue, with ex-Care Minister Paul Burstow already throwing his hat into the ring calling for 20% of the funds to be allocated to social care. Big headlines on increased NHS spending might impress in the short term, but as the stark reality of the NHS funding gap is realised, politicians must remember that much more is at stake than just the headlines.
Measurement and evaluation