HSJ’s must read analysis on the government’s spending review
Today’s non-spending review news: Hunt agrees to Acas talks over junior doctors contract
Today’s talking point: While the CSR deal is a success, it is far from an unmitigated one
What the announcement means for health and care
This afternoon’s spending review announcement has taken the shine off yesterday’s preview of “frontloaded” funding for NHS England in a big way. Documents published as the chancellor finished his speech revealed that much of the real terms funding increase promised for NHS England over the parliament will come at the expense of huge real terms cuts to other areas of Department of Health spending.
The £15.3bn pot of DH funding that pays for health education, public health, capital projects and other arm’s length bodies will be cut to £13.2bn by 2020-21. The Health Foundation calculates the real terms cut at 21 per cent.
Worse than that, much of the cut – £1.5bn in cash terms – will come in 2016-17. Health Foundation chief economist Anita Charlesworth described the move as a “massive exercise in robbing Peter to pay Paul”, while Nuffield Trust chief executive Nigel Edwards said it was now clear that the NHS England funding announced yesterday “may have come at the cost of services that the NHS depends on”.
We have an exclusive interview with Health Education England chief executive Ian Cumming, commenting on the challenges in his budget; and have explored the new round of cuts facing public health – specifically a 4 per cent real terms reduction each year.
Elsewhere, analysis of the spending review reveals:
- The better care fund will be frozen in real terms in 2016-17 – as NHS England had requested. The NHS’s contribution will be frozen thereafter; however, local government will put an increasing amount into the pot from 2017-18, rising to £1.5bn in 2020-21. This will not be funded from NHS or Department of Health budgets, though. Meanwhile, each area of England will in 2017 be asked to set out a plan for bringing together health and social care services, “so that by 2020 health and social care are integrated across the country”. The BCF will increasingly be seen as the lowest rung integration option, which areas “will be able to graduate from” if they demonstrate sufficient integration credentials, the spending review said.
- The government is considering selling off the Department of Health’s revenue streams from private finance deals.
- The Treasury has identified almost £2bn in NHS estate assets to be sold over the next five years.
- The NHS will be encouraged to create “long term partnerships” with the private sector to develop new models of care and upgrade diagnostics services.