Hammond"s budget bows to demands for social care cash injection

Philip Hammond responded to the growing crisis in social care in England by pledging to put £2bn extra into it over the next three years and also produced an unexpected £425m to help the NHS cope better with winter and transform how it works.

Additional money for social care was necessary both to improve the help older people receive as the number of over-75s grows quickly in the coming years and also to ease the huge pressures the NHS is under, the chancellor said in his statement.

He also promised that a green paper, due late this year, would set out options for resolving the financially and politically pressing question of how to fund social care in the long term, given the population is set to continue ageing.

The cash boost, £1bn of which councils will receive to use in 2017-18, follows dramatic warnings from charities, health organisations and the care regulator that England’s social care system is reaching “a tipping point” after years of budget cuts.

“Today, our social care system cares for over a million people and I pay tribute to the hundreds of thousands of carers who work in it. But the system is clearly under pressure. And this in turn puts pressure on our NHS,” Hammond told MPs.

“Today there are half a million more people aged over 75 than there were in 2010 and there will be 2 million more in 10 years’ time. Today I am committing additional grant funding of £2bn to social care in England over the next three years, with £1bn available in 17/18.”

Hammond made clear that he expected “local authorities to act now to commission new care packages” for the coming financial year. Those would enable mainly frail, elderly people to be better supported in order to keep living safely at home and also, in particular, help reduce the number of older patients trapped in hospital – sometimes for many months – despite being medically fit to leave, because social care in their area is inadequate.

The £2bn was significant because Hammond had rejected widespread cross-party appeals for a cash injection for social care ahead of both his autumn statement last November and the local government finance settlement a few weeks later.

But health, social care and older people’s organisations gave the £2bn a lukewarm response. It was much less than was needed to ensure all older people got the care they needed, they said.

“Although we warmly support the chancellor’s announcement of a social care green paper in the autumn, this is tempered by some anxiety that today’s emergency funding package, welcome though it is, may not be enough to keep the system going until a new, sustainable approach is put in place,” said Caroline Abrahams, Age UK’s charity director.

Experts’ recent estimates of the amount needed between now and 2020, after six years of Whitehall cuts to town hall budgets, “were all higher than the amount announced today”, she said. “We also need to know more about where the additional £2bn is coming from and whether it is genuinely new money or not,” she added.

“Our concern is that there could be big trouble ahead in some places for older people needing care and their families if providers continue to shut up shop and councils find it impossible to spread the jam any thinner to meet rising demand.”

Nigel Edwards, chief executive of the Nuffield Trust health thinktank, said the £1bn would plug only half of the £2bn funding gap it expected in 2017-18. “More and more vulnerable people are therefore going to be denied the help they need in the next year,” he said.

Doctors welcomed Hammond’s announcement of £100m to pay for more GPs to work at hospitals in order to help take the pressure off A&E units by triaging and treating less seriously ill patients. Expanding such schemes, which already operate at some hospitals, would help the NHS cope better with next winter, the chancellor said.

“Having primary care on site will undoubtedly benefit patients,” said Dr Chris Moulton, vice-president of the Royal College of Emergency Medicine, which represents A&E doctors. But the British Medical Association and NHS Providers said they doubted there were enough GPs to staff such services, given the chronic lack of family doctors.

Hammond also found £325m of extra money for the NHS’s capital budget to help turn the first batch of NHS England’s controversial sustainability and transformation plans (STPs) into reality. It will enable six to 10 “pioneer” STPs, which the NHS chief executive, Simon Stevens, will identify later this month, to go ahead, shaking up how care is delivered in their area, particularly by providing many more services outside of hospitals.

However, the £325m comes after Jeremy Hunt moved £1.2bn of the NHS’s capital budget into its revenue budget this year, in order to help struggling hospitals. He plans an identical £1bn switch in 2017-18 and, the Health Service Journal disclosed on Wednesday, further raids of £500m and £250m in the two years after that.

Hammond"s budget bows to demands for social care cash injection

Hammond"s budget bows to demands for social care cash injection

Philip Hammond responded to the growing crisis in social care in England by pledging to put £2bn extra into it over the next three years and also produced an unexpected £425m to help the NHS cope better with winter and transform how it works.

Additional money for social care was necessary both to improve the help older people receive as the number of over-75s grows quickly in the coming years and also to ease the huge pressures the NHS is under, the chancellor said in his statement.

He also promised that a green paper, due late this year, would set out options for resolving the financially and politically pressing question of how to fund social care in the long term, given the population is set to continue ageing.

The cash boost, £1bn of which councils will receive to use in 2017-18, follows dramatic warnings from charities, health organisations and the care regulator that England’s social care system is reaching “a tipping point” after years of budget cuts.

“Today, our social care system cares for over a million people and I pay tribute to the hundreds of thousands of carers who work in it. But the system is clearly under pressure. And this in turn puts pressure on our NHS,” Hammond told MPs.

“Today there are half a million more people aged over 75 than there were in 2010 and there will be 2 million more in 10 years’ time. Today I am committing additional grant funding of £2bn to social care in England over the next three years, with £1bn available in 17/18.”

Hammond made clear that he expected “local authorities to act now to commission new care packages” for the coming financial year. Those would enable mainly frail, elderly people to be better supported in order to keep living safely at home and also, in particular, help reduce the number of older patients trapped in hospital – sometimes for many months – despite being medically fit to leave, because social care in their area is inadequate.

The £2bn was significant because Hammond had rejected widespread cross-party appeals for a cash injection for social care ahead of both his autumn statement last November and the local government finance settlement a few weeks later.

But health, social care and older people’s organisations gave the £2bn a lukewarm response. It was much less than was needed to ensure all older people got the care they needed, they said.

“Although we warmly support the chancellor’s announcement of a social care green paper in the autumn, this is tempered by some anxiety that today’s emergency funding package, welcome though it is, may not be enough to keep the system going until a new, sustainable approach is put in place,” said Caroline Abrahams, Age UK’s charity director.

Experts’ recent estimates of the amount needed between now and 2020, after six years of Whitehall cuts to town hall budgets, “were all higher than the amount announced today”, she said. “We also need to know more about where the additional £2bn is coming from and whether it is genuinely new money or not,” she added.

“Our concern is that there could be big trouble ahead in some places for older people needing care and their families if providers continue to shut up shop and councils find it impossible to spread the jam any thinner to meet rising demand.”

Nigel Edwards, chief executive of the Nuffield Trust health thinktank, said the £1bn would plug only half of the £2bn funding gap it expected in 2017-18. “More and more vulnerable people are therefore going to be denied the help they need in the next year,” he said.

Doctors welcomed Hammond’s announcement of £100m to pay for more GPs to work at hospitals in order to help take the pressure off A&E units by triaging and treating less seriously ill patients. Expanding such schemes, which already operate at some hospitals, would help the NHS cope better with next winter, the chancellor said.

“Having primary care on site will undoubtedly benefit patients,” said Dr Chris Moulton, vice-president of the Royal College of Emergency Medicine, which represents A&E doctors. But the British Medical Association and NHS Providers said they doubted there were enough GPs to staff such services, given the chronic lack of family doctors.

Hammond also found £325m of extra money for the NHS’s capital budget to help turn the first batch of NHS England’s controversial sustainability and transformation plans (STPs) into reality. It will enable six to 10 “pioneer” STPs, which the NHS chief executive, Simon Stevens, will identify later this month, to go ahead, shaking up how care is delivered in their area, particularly by providing many more services outside of hospitals.

However, the £325m comes after Jeremy Hunt moved £1.2bn of the NHS’s capital budget into its revenue budget this year, in order to help struggling hospitals. He plans an identical £1bn switch in 2017-18 and, the Health Service Journal disclosed on Wednesday, further raids of £500m and £250m in the two years after that.

Hammond"s budget bows to demands for social care cash injection

BMA calls for extra £10bn a year for NHS in Hammond"s budget

The British Medical Association has urged the government to increase health spending by £10bn a year to bring funding into line with other leading European economies and shore up the NHS.

The union for doctors said increasing health spending to a proportion of GDP that matched that of the 10 leading economies across Europe could pay for at least 35,000 extra beds a day and several thousand more GPs.

In a letter to the chancellor, Philip Hammond, before Wednesday’s budget, the BMA council chair, Dr Mark Porter, wrote: “Our members report that services are truly at breaking point, with unprecedented rising patient demand met only with financial restraint and directives for the NHS and social care to make huge, unachievable savings through sustainability and transformation plans (STPs) across England.

“We are not calling for more than other comparable nations, we are simply calling for you to match the average spending of other leading European economies. Based on our analysis of the figures available, this would, in 2015, have equated to an increase of £10.3bn for NHS funding; an increase which is desperately needed.”

The BMA’s call for substantial extra investment comes at a time when the NHS is feeling the strain amid rising demand, staff shortages and pressures on its finances. The service is supposed to be seeking to achieve £22bn in efficiency savings by 2020, which NHS England chief Simon Stevens said would still leave the service with an £8bn funding gap.

However, the health service in England is on course to overspend by £1bn by the end of the current financial year after running up a deficit of £2.45bn in the previous 12 months.

The BMA has been a vocal critic of the STPs, claiming they are unworkable and will not secure the sustainability of the NHS as they are intended to do but threaten it by reducing services on a drastic scale.

The reference in the letter to Hammond to the number of beds that could be funded is particularly emotive as several thousand beds in acute district general hospitals face being axed under STPs submitted by 44 areas.

Additionally, lost bed days due to patients being unable to be discharged because of constraints on community or social care, have hit record levels in recent months.

They were also partially blamed for a deterioration in NHS finances in England in the last three months of last year as providers lost income from elective operations because of a lack of capacity.

The BMA’s analysis suggests that the 10 leading economies across Europe spend an average of 10.4% of their GDP on health in comparison with the UK’s 9.8%, using the current definition from the Organisation for Economic Co-operation and Development. According to this, the UK’s spending on health in 2015 should have been £10.3bn higher than it was.

Porter said if the government matched its peer group it could recruit an extra 10,000 GPs, along with other healthcare professionals, and improve surgeries so that practices could host more staff and deliver additional appointments to patients.

It could also reverse cuts already made to the public health budget rather than introduce further reductions of almost 4% up until 2020, he added.

“The crisis currently facing the NHS and social care is well known and becoming increasingly severe – the government cannot remain a bystander any longer,” Porter wrote.

“An entire system under such strain is not due to frontline financial mismanagement, or individual chief executives’ poor decision making, it is due to the conscious underinvestment in our health service.”

A Department of Health spokeswoman said: “We are committed to the NHS, which is why total health spending is above the OECD average as a percentage of GDP, and why we are investing £10bn in the NHS’s own plan for the future, including almost £4bn this year.

“What’s more, the NHS was ranked the best and most efficient healthcare system in the world by the independent Commonwealth Fund, showing that we make every bit of spending count.”

BMA calls for extra £10bn a year for NHS in Hammond"s budget