Philip Hammond has been roundly criticised for failing to heed warnings and provide additional funding for the NHS or social care in his first autumn statement since become chancellor.
Mr Hammond set out no new plans for health and social care in his autumn statement delivered to the Commons earlier today.
“The lack of investment in social care spells disaster in the NHS”
In addition, accompanying documents made no mention of the NHS or social care, instead focusing on public finance forecasts as well as announcing new infrastructure and housing investment plans.
However, the chancellor did state that departmental expenditure plans would remain in place and spending would only grow in line with inflation until it was re-examined during the next spending review.
As expected, he also raised the National Living Wage, from £7.20 to £7.50 by April 2017.
In his speech, Mr Hammond said: “Putting the public finances on a sustainable path is vital to securing a strong and stable economy.
“Departments will therefore continue to deliver overall spending plans set at the Spending Review 2015,” he said. “The efficiency review announced at Budget 2016 will update in autumn 2017.”
He also reiterated a previous statement that NHS spending was growing by £10bn in real terms by 2021, echoing prime minister Theresa May during prime minister’s questions this afternoon.
“The Treasury has missed a golden opportunity to ease the strain on the NHS”
Ms May was forced to repeatedly answered questions about the social care crisis, after stakeholders from the sector had made last-minute calls for more funding ahead of the autumn statement.
She said the government was putting more cash into social care through the better care fund, was giving councils more “opportunities” through the local government precept and helping to ensure health and social care work together to tackle the problem of delayed transfers of care.
But, in a strongly-worded response, NHS Confederation chief executive Stephen Dalton branded the absence of health and social care in the statement as a “missed opportunity” to ease the strain on the NHS and social care sector.
His disappointed was echoed by other stakeholder groups, including charities and trade unions, which had specifically called for an end to the 1% cap on pay rises for nursing and other NHS staff.
Mr Dalton said: “The Treasury has missed a golden opportunity to ease the strain on the NHS. While the government is right to review long-term spending plans, social care services are in crisis right now.
“Our staff delivering services on the frontline this winter will find it extraordinary that the government has turned a blind eye to the stresses and strains being felt in the health and social care system,” he said.
“Services supporting our elderly and vulnerable are at breaking point now”
He added: “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.”
Care England, the largest representative body for independent providers of adult social care, expressed its disappointment that the chancellor had “yet again” ignored the sector.
Chief executive Professor Martin Green said: “Unfortunately the lack of investment in social care spells disaster in the NHS and potentially a perpetual winter”.
He also reiterated previous warnings that, while the adult social care sector “applauded” the rise in the living wage, it needed to be accompanied by “commensurate funding for the sector”.
Professor Rhidian Hughes, chief executive of the Voluntary Organisations Disability Group, which represents over 80 voluntary and charity social care disability provider organisations, agreed.
“While the national living wage is welcomed, there is no additional funding in place to adequately cover the costs of such measures,” he said. “In addition, there are no breaks, like corporation tax reductions, for voluntary organisations.
“The chancellor has missed an important opportunity to put social care funding back on track,” he stated. “Consequently, this country is seriously compromising its duty to provide essential care and support to millions of disabled and older people.”
The Local Government Association was also highly critical at the lack of attention paid by Mr Hammond to social care.
“Councils, the NHS, charities and care providers have been clear about the desperate need for the chancellor to take action to tackle the funding crisis in social care. It is unacceptable that this has not been addressed in the autumn statement,” said LGA chair Lord Porter.
“Extra council tax-raising powers will not bring in enough money to alleviate the pressure on social care and councils will not receive the vast majority of new funding in the Better Care Fund until the end of the decade,” he said. “Services supporting our elderly and vulnerable are at breaking point now.”
“Nursing staff have endured reductions in their standard of living since 2010”
Meanwhile, Unison general secretary Dave Prentis said there was “precious little, if anything, for our beleaguered public services” in the chancellor’s statement.
“Public service workers and the health, education and local council services they provide are hurting badly,” he said. “Aside from those on the very lowest wages, the pay misery for school, hospital and town hall staff goes on.”
He added: “The government’s stubborn refusal to end the 1% pay cap means wages are lagging way behind rising food and fuel prices, causing real financial hardship.
Pay rise above 1% ‘needed to ease nurse crisis’
The Royal College of Nursing highlighted that more than 60,000 people had signed a petition calling on the government to scrap the 1% pay cap in order to alleviate the retention crisis.
Prior to the statement, the college had also warned that unless nurses’ pay reflected the increase in cost of living, trusts would struggle to attract enough staff to provide safe patient care.
Janet Davies, RCN chief executive and general secretary, said: “The current crisis in the nursing workforce has been building through years of pay restraint. Today there was an opportunity to alleviate it, and the chancellor has chosen not to take it.
“Nursing staff have endured reductions in their standard of living since 2010, with a 14 % real terms cut in what they take home – despite mounting demands on them and the urgent need for more staff,” she said.
“The message many nurses will have taken home today is that fair pay, and action to recruit and retain enough staff to deliver NHS care, is not a priority for their government,” said Ms Davies.
“This is grim news for the NHS”
Professor John Appleby, chief economist of the Nuffield Trust health think-tank, warned that elderly and disabled people would “pay the price” for the chancellor’s “failure to heed any of the calls for more money for social care”.
“In addition to the considerable human cost of this lack of funding, starving social care of cash is also having a serious knock-on effect on the NHS, with more and more patients trapped in hospital beds when they could leave with more local authority support,” he said.
“What’s more, the increase in the living wage announced today, whilst welcome for workers, will mean additional costs of around a third of a billion for social care providers from next year,” he said.
King’s Fund chief economist on health policy John Appleby
Professor Appleby added: “The autumn statement also underlines that the austerity measures affecting all public services will continue till the end of the decade. This is grim news for the NHS.
“It’s impossible to see how the NHS will get through the year 2018-19, when spending per person will fall,” he said. “Something will have to give, whether it’s ballooning waiting lists, record deficits, or having to refuse patients new drugs.”
Similar sentiments were also made by other organisations and commentators, including the Association of Directors of Adult Social Services, Carers UK, the Health Foundation and the King’s Fund.