Many of the larger increases fall to departments that manage the symptoms of acute societal needs: social care, policing, and criminal justice. There is a real risk that the additional spend in 2020/21 simply papers over the cracks by dealing with crises rather than providing the long-term investment needed for sustained improvements to our living standards and health. The Chancellor’s announcement doesn’t provide any additional funding for working-age social security, where austerity continues, with child poverty rates expected to rise further.
Next year’s small increase in the public health grant will fall significantly short of the £1bn required to reverse five years of cuts. It fails to match the rate of increase in budget for NHS front-line services and so will still represent a shrinking share of overall health spend. This is despite evidence that further public health spending is three times more productive than spending on health services.
The extra money announced by the Chancellor for adult social care could amount to an additional £1bn spending for adult social care, depending on decisions made locally. This is welcome, but broadly only keeps pace with rising demand, with no respite for the many thousands of people living with unmet social care needs. And around a half needs to be raised by council tax – a difficult prospect in areas of the greatest deprivation where need is highest.
And the 2.9% increase for the Department of Health and Social Care falls short of the absolute minimum of 3.3% needed to maintain care, and some way short of the 4.1% required to invest in modernising the NHS. It is also less than the overall rise in public spending. While it is positive to see a shift in spending towards wider public sector priorities, we would like to see a greater emphasis on investing in long-term measures designed to prevent poor health.
The 2019 Spending Round marks the end to cuts to public services, but undoing the impact of nine years of austerity will take more than one year of increased spending. Major challenges remain for health, social care and the wider public services that drive health outcomes and inequality.
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