Senior health and care leaders and policy experts had appealed for urgent new funding to stave off a crisis ahead of today’s announcement.
Chancellor Philip Hammond failed to deliver any new funding, only repeating the government's controversial claim to have increased NHS funding by £10bn - a claim that has been questioned by the House of Commons health select committee.
Mr Hammond promised to maintain current departmental spending plans, under which NHS spending is protected, with spending rising only with inflation, until the next spending review in 2020 when plans will be reviewed.
In the debate following the statement Mr Hammond said NHS trust deficits were ‘not particularly unusual’ and were being managed within the NHS. The Treasury, he said, would continue to keep a ‘very close eye’ on the NHS. A King's Fund report earlier this year found that around half of NHS trusts were predicting a year-end deficit, along with around a quarter of CCGs.
Former Labour health secretary Andy Burnham said it was ‘unbelievable’ there was no new money for social care, and challenged the chancellor to justify prioritising funding for new grammar schools over ‘the care of older people’. Mr Hammond said local authorities had been given the social care precept and access to the Better Care Fund, but that they had to ‘manage their budgets as they think best’.
Conservative health select committee chair, former GP Dr Sarah Wollaston, repeated the CQC’s warning that social care was at a ‘tipping point’ and said she was ‘disappointed’ the Better Care Fund had not been brought forward yet.
Londonwide LMC chief executive Dr Michelle Drage said the chancellor’s economic announcement fell ‘far short’ of what was required to address the challenges faced by general practice. ‘It contains nothing new for the vanguard of the UK healthcare system,' she said.
NHS Confederation chief executive Stephen Dalton said the Treasury had ‘missed a golden opportunity to ease the strain on the NHS’.
Mr Dalton said the chancellor was right to review long-term spending plans, but that ‘social care services are in crisis right now’.
NHS staff, he added, would find it ‘extraordinary’ that the government had ‘turned a blind eye to the stresses and strains being felt in the health and social care system’.
‘Relying on a political rhetoric that promises to protect the NHS, but fails to acknowledge that a cut in social care results in a cost to the NHS, is an economic deception,’ he said.
NHS Clinical Commissioners chief executive Julie Wood said it was ‘disappointing’ that Mr Hammond had not listened to voices across health and social care.
‘We know the government feels it has given the NHS the money it has asked for, but we also know the delivery of the Five Year Forward View was predicated on a number of conditions that have not been met and funding has not kept pace with demand.’
BMA chair Dr Mark Porter accused the chancellor of ignoring calls from the health sector for much needed new funding.
‘His claims that the NHS will receive £10bn in extra funding are misleading, as in reality the increase in health spending is less than half of that. This comes as figures released today show that the UK spends less on healthcare than the EU-average,' he said.
‘The NHS has been under enormous pressure for some time now and things are steadily getting worse.’
Struggling services desperately needed a plan for long-term sustainability, warned Dr Porter.
Responding to the announcement, Labour shadow chancellor John McDonnell said he feared a funding and care crisis this winter. The government was failing patients and NHS staff and the social care system would not be secure without new long-term funding, he said.
King's Fund policy director Richard Murray said: ‘The absence of new money for health or social care means that the already intense pressures on services will continue to grow.
‘The lack of extra money for social care funding, in particular, means we are likely to see an already threadbare safety net stretched even more thinly. This will impact on some of the most vulnerable people in society, and so goes against the government’s commitment to creating a country that works for everyone. While the increase to the national living wage is welcome, it will add to the cost faced by local authorities and social care providers, making an already fragile market even more unstable.
‘The government will also need to look again at health funding in future. The planned increases in health spending are not enough to maintain standards of care, meet rising demand and transform services. In particular, the pressures will peak in 2018/19 and 2019/20, when there is almost no planned growth in real-terms NHS funding.'