We won’t have to speculate about the details of the Labour’s first Budget much longer. But one tradition as old as time has been confirmed by the Treasury: the National Health Service is getting more cash.
‘Our NHS is the lifeblood of Britain,’ the Chancellor Rachel Reeves has said ahead of unveiling her full Budget tomorrow. ‘That’s why I am putting an end to the neglect and underinvestment it has seen for over a decade now.’ This is set to include £1.57 billion of capital spending to expand surgical hubs and provide more equipment. An additional £1.8 billion worth of funding will also be announced to help Labour make good on its promise to expand appointment access by 40,000 per week – and to get the 7.6 million-long NHS England waiting list on a downward trajectory.
But has the NHS really experienced ‘underinvestment’? A long line of governments, both Tory and Labour, have raided capital budgets to increase day-to-day spending, which helps explain the dire state of some hospitals and the strains on equipment. But so much of that money was redirected to other NHS budgets, which helps explain why (excluding Covid funding), the NHS budget in real terms is at its highest level on record.
What are patients getting for all that cash, besides the service being an international laggard for health outcomes? This is a point that Health Secretary Wes Streeting has been making for years, as both he and the Prime Minister have toughened up their talk on the health service and insisted there will be no cash without reform.
Yet it looks like this first Budget is going to deliver just that: more money for the NHS, while reform – so far – has been limited to vague promises of change and an NHS 'consultation’ which has seen members of the public write in with their ideas (and feedback) for the health service.
Streeting insists he needs time for reform to materialise. Asked this morning if patients will be waiting on trolleys and hospital hallways this winter, he said that ‘they will be this winter, and I don’t think that’s acceptable'.
There may be patience for the Health Secretary to get a grip on the momentous challenge to reform the service. But if taxes (as expected) rise substantially in this Budget, and the NHS gets more money, the expectation will be that access and outcomes on the NHS also start to improve. Every fiscal event where more money is dished out – but reform is not – is going to raise the stakes even higher for a government that has been insistent that one does not exist without the other.
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