Responding to the Autumn Budget, Sarah Woolnough, Chief
Executive of The King's Fund, said:
‘The generous settlement the NHS received at the Spending Review
earlier in the year and its apparent protection today will help
the health service just about keep its head above water as it
battles a long list of financial challenges. Nonetheless, rising
demand, fragile social care, industrial action, major workforce
payouts and potential drug price increases mean health and care
leaders still face a daunting task.
‘The scrapping of the two-child benefit cap and investment in
Neighbourhood Health Centres are bold steps toward improving the
public's health and reducing pressure on the NHS long-term.
However, the government still lacks a clear plan on how it will
deliver its NHS reforms or stabilise social care and for how new
private investment partnerships will avoid the costly mistakes of
the past.'
Two-child benefit cap and public health
‘The lifting of the two-child benefit cap could be significant in
tackling deep health inequalities. It will take hundreds of
thousands of children out of poverty, a key driver of health
conditions from obesity to asthma. Conditions like these can lead
to lifelong struggles with health, affecting quality and
ultimately length of life as well as long-term pressure on NHS
budgets. Alongside a cross-government approach with measures like
the ‘milkshake tax', we welcome ministers using levers other than
direct NHS funding to improve health outcomes.
‘Other policies such as an increase to gambling duty will build
on this too, however the government could have gone further.
There is space for tighter restrictions on junk foods ads and the
move to raise taxes on electric vehicles could set back efforts
to increase their uptake and improve air quality. Overall, it
represents steps in the right direction but there is room for
improvement in creating a more coherent public health policy.'
Finances
‘This Budget lands against a bleak economic backdrop, yet health
spending appears to have emerged relatively protected. There is
still a long list of challenges alongside an intense political
focus on driving down NHS performance targets - including waits
for routine hospital care – which will mean the NHS is forced
into trade-offs. It will have to divert its limited resources
into achieving these targets at the detriment of other areas
equally important to health outcomes and public satisfaction.
‘The full cost of the government's restructure of the NHS is
still unknown. Redundancy payments may be affordable this year
because of a new agreement with HM Treasury to bring forward
planned future spending, but the opportunity costs of
restructuring the NHS while embarking on the most significant set
of NHS reforms in a decade will be considerable. It also risks
distracting senior management at a time when there should be a
laser focus on improving performance.
‘The £300 million announced for investment in technology is
welcome in showing the government's focus on improving efficiency
but in the context of the previously announced £10 billion over
three years in investment in this area it is a relatively small
sum.'
Neighbourhood Health Centres
‘The government's announced investment in Neighbourhood Health
Centres is welcome. It shows ministers are looking at different
ways to release new funding and prioritising delivery of care
closer to home. Successive governments have not made progress on
shifting care out of hospitals and ministers must demonstrate a
clear break from this poor track record.
‘The use of public private partnerships at a large scale in the
NHS should be treated with caution given the repeated challenges
previously. Ministers must prove they have learnt from the
mistakes of schemes like PFIs by implementing appropriate checks
and balances to design schemes more carefully to ensure value for
money.
‘Delivering neighbourhood health requires more than new or
upgraded buildings. So that care is delivered in these new ways,
rather than simply shifting old models out of hospital to
community facilities, we need to expand diagnostic capacity,
improve digital infrastructure and build a truly sustainable
workforce. And a drive for improved coordination of healthcare,
including with social care, which was notably absent from the
Chancellor's remarks, will be necessary to improve the experience
for many patients.'
