Today’s Budget was historic for being the first to be delivered by a female Chancellor. But what did Rachel Reeves’ fiscal address, the first from a Labour government since March 2010, have in store for the NHS and healthcare more widely?

What was announced?

Described as a Budget to 'fix the foundations and deliver change', the Chancellor left it right to the end of her speech to focus on the NHS – but made a number of major healthcare announcements.

This included:

• A £22.6bn increase in day-to-day health spending.

• A £3.1bn increase in capital spending, for this year and next.

• The funding needed to deliver an extra 40,000 elective appointments per week (and 2 million more appointments a year), as per the government’s manifesto promise.

• £1bn of health capital investment next year to address the backlog of repairs and upgrades and increase capacity for tens of thousands more procedures.  

• A further £1.5bn for new beds in hospitals, new capacity for over a million additional diagnostic tests and new surgical hubs and diagnostic centres to speed up treatment times.

In addition, Reeves announced that Health Secretary Wes Streeting will publish his review into the controversial New Hospitals Programme (a legacy from the previous Conservative-led governments) in the new year, and that the much-discussed 10 Year Health Plan will be released in spring (informed by the national conversation on the NHS launched last week).

The government said today’s announcement is an integral first step in reducing waiting lists – one of its five key missions - and puts the NHS on course to meet the commitment that 92% of people wait less than 18 weeks to start treatment.

“Our NHS is the lifeblood of Britain. It exemplifies public services at their best, there for us when we need it and free at the point of use, for everyone in this country,” Reeves said. “We will be known as the government that took the NHS from its worst crisis in its history, got it back on its feet again and made it fit for the bright future ahead of it.”

Wes Streeting added: “Our NHS is broken, but it’s not beaten, and this Budget is the moment we start to fix it. Alongside extra funding, we’re sending crack teams of top surgeons to hospitals across the country, to reform how they run their surgeries, treat more patients, and make the money go further.”

Will it make a difference?

Despite the Budget boost, there have been fears that this is only more sticking plaster – simply allowing the NHS to stand still, rather than making any real progress.  

Some have argued that the NHS needs consistent budget increases just to reach parity and meet costs before anything can be done about more treatment, innovation or increased productivity.

While the NHS was seen as one of the main winners from the Budget, a more detailed scrutiny of what was announced potentially paints a slightly different – or at least a more nuanced – picture.  

NHS Confederation has produced a very thorough summary and analysis of the Budget, which argued that the numbers announced might not be exactly as they seem.

“While the Chancellor said this [extra] funding would go towards funding ‘day-to-day’ NHS budget, this front-loading is, in part, to pay for previously unfunded commitments such as pay deals (estimated by the Nuffield Trust before the Budget to be around £4.8 billion) and funding existing deficits. It is not yet clear how much health leaders will be able to spend on frontline service improvements,” the analysis said.

It also argued that poor transparency continues to hamper our ability to understand how much money the NHS actually gets.

A very important Budget

We know the current landscape remains very challenging for NHS Trusts. When we published our White Paper on elective care waiting times in late June, just before the general election, the overall waiting list number stood at 7.16m.

Since then, despite the government’s commitment to reducing waiting lists by providing 40,000 extra appointments weekly, this number has continued to rise. According to the latest available data (up to August), waiting lists have grown again in the last three months to 7.25m.

This has made the impact of the Budget, and how it feeds into the NHS’s priorities, even more important. Although the extra funding is very welcome, it’s also crucial that a one-size-fits-all approach isn’t implemented. Any approach must be targeted at the geographical locations and specialties that are most in need of intervention – only then will we start to see progress.  

There are reasons to be optimistic. From our analysis of the latest data, we can see that dozens of trusts have seen their waiting lists increase by 10% or more, but at the same time there are five trusts who have seen their waiting lists fall by 20% or more.

Spending some time on investigating why this is the case and reviewing those organisations that have dramatically reduced their waiting lists, can enable us to see where learning could be shared to help successfully bring waits down.

“While we’re delighted to see the boost in funding, we are joining others in saying that it’s still not enough to solve the fundamental issues at play in the NHS,” Karina Malhotra, our Founder and Managing Director, said.

“Wes Streeting is right to point out that one Budget alone won’t be able to fix the NHS, it’s a far more long-term project than that, but equally it would be good to have a clearer idea of the detail behind the government’s healthcare agenda. Where are these 40,000 extra appointments a week that were promised coming from and how will this be paid for?”

She added: “Equally, there are wider issues surrounding productivity, staff morale and training – all crucial to create a much better functioning system – that still haven’t been addressed, and there was barely a mention of mental health.”

“It would be great to see more detail on the pledges made today to see how the government plans to truly change and reform the NHS.”

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