Isabel Hardman

The Treasury’s big NHS gamble

The Treasury's big NHS gamble
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How can the government really promise to clear the NHS backlog when it isn't investing in the necessary staff to carry out the treatments? That's the question many in the health service are asking after this week's Spending Review. Sure, the Chancellor announced a £5.9 billion commitment on capital spending, which will increase bed capacity, set up more diagnostic centres and improve technology and data systems, but these don't make sense unless you have the people working in them.

The government had led the health world to believe that it would offer some kind of financial clarity on workforce in the Spending Review. In its response to this petition on cancer care on 19 October, it said: 

'Allocations and profiles will be confirmed as part of the Spending Review, which will set out the Government's spending plans for health and social care for future years, including the NHS Workforce. The Spending Review is set to be announced on 27th October 2021.'

There had been calls for a multi-year settlement on workforce to allow Health Education England (HEE) to plan property – this is a long-term problem that takes a good period of time to resolve, after all. But as I reported in the i paper his week, instead HEE seems to be facing a real-terms cut in its funding, with a row still ongoing about whether the NHS or Department of Health (or neither) will stump up the cash to prevent this cut.

It seems to be a Treasury problem, rather than the Health department, funnily enough. When I spoke to a source close to the Health Secretary, they told me that the government was working on 'massive investment in day-to-day spending and capital to tackle waiting lists and ensure people get the care they need as quickly as possible,' but added: 'We are making progress recruiting more nurses and doctors but yes, more needs to be done.'

This is not the Treasury line, which is that the government has basically fixed the NHS backlog in terms of funding and now the health service needs to get on with it and become more efficient. It's not dissimilar to the claim that this is the government that has delivered 'historic' reform to social care when the funding isn't going to social care yet and won't actually reform the sector so that quality improves at all. It's quite a gamble to use this much smoke and this many mirrors on a matter that is so emotive and so salient with voters.

Written byIsabel Hardman

Isabel Hardman is assistant editor of The Spectator and author of Why We Get the Wrong Politicians. She also presents Radio 4’s Week in Westminster.

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