Unions representing nursing and midwifery have welcomed the announcement of a rise in funding for the NHS, but have questioned whether it will be sufficient to keep pace with demand on services.
The prime minister has announced today that the government is to increase NHS England’s current £114bn budget by an average of 3.4% in each of the next five years.
“In 2023-24 there will be about £600m a week more in cash going into the NHS”
The real terms’ increases – which would amount to an extra £20bn a year by 2023-24 – was revealed by Theresa May on Sunday during the BBC’s Andrew Marr programme.
Described as a “birthday present” for the NHS in its 70th year, the prime minister hinted that the funding increase would be partly funded through tax rises and what she called a “Brexit dividend”.
“I can tell you that what I’m announcing will mean that in 2023-24 there will be about £600m a week more in cash going into the NHS,” she said during her interview with Andrew Marr.
“That will be through the Brexit dividend – the fact that we’re no longer sending vast amounts of money every year to the European Union once we leave the EU,” said Ms May.
Further details of the funding rise are due to be revealed on Monday and follow an earlier pledge from Ms May to negotiate a long-term funding settlement for the health service.
“The extra funding is a welcome birthday present, but we need to make sure there are enough candles on the cake”
In response, Janet Davies, chief executive and general secretary of the Royal College of Nursing, welcomed the announcement of the 3.4% increase.
“Theresa May and [health secretary] Jeremy Hunt are to be congratulated on securing this increase, which is a great deal more than some of the sums being talked about earlier this year,” she said.
“The extra money should enable trusts to invest more in staff and, therefore, reverse some of the cuts in patient care nurses are reporting to us,” said Ms Davies.
“The extra funding is a welcome birthday present for the NHS, but we need to make sure there are enough candles on the cake,” she added.
But she highlighted that health thin-tanks had previously warned that only an increase above 4% would be enough to genuinely transform the NHS into the 21st century service all nurses want.
She also cautioned that the government must be “under no illusion that there can be no long-term solution for the NHS without a solution for social care too”.
“Nursing staff would tell ministers that it is a mistake simply to celebrate the NHS while leaving out social care,” she said, noting that social care cuts have piled pressure onto hospitals.
“NHS staff will also want a commitment that the pay deal they’ve just accepted isn’t a one-of”
Similarly, she noted that the funding increase was for the NHS only and that extra money “must be found for vital services like public health and staff training that come out of other budgets”.
Meanwhile, Unison general secretary Dave Prentis said that, while the funding package was welcome, it was “not enough”.
“Any extra money for the NHS will be welcomed by the staff whose dedication and hard work have seen it through the toughest of times,” he said. “But it’s not enough.
“It isn’t the long-term funding package health workers will have been hoping for, and there’ll be fears of strings attached,” said Mr Prentis.
“Although the billions promised will keep services running, it falls far short of what’s needed to save social care services and is unlikely to be enough to keep pace with growing demand,” he said.
In addition, the Unison leader warned that money would be needed to fund future staff pay rises following the recently agreed three-year deal, which covers 2018-19 to 2020-21.
“NHS staff will also want a commitment that the pay deal they’ve just accepted isn’t a one-off – that there’ll be extra funding in future for above inflation wage rises,” he said.
New chief executive takes over at midwives’ union
Gill Walton, chief executive and general secretary of the Royal College of Midwives, welcomed better funding for the NHS but also questioned whether the deal announced will be sufficient to meet rising demand and to improve services.
“Specifically, the RCM will be seeking precise clarification that the plan for spending by NHS England of 3.4% extra over five years will meet existing policy priorities for maternity services” she said.
For example, she highlighted a workforce pledge for 3,000 more midwives in the NHS in England by 2021, maternity safety and mental health initiatives, and Better Births, the government’s plan for maternity transformation in England.
Ms Walton added “With most respected commentators and economists arguing for at least a 4% increase over a longer time period, we have major concerns that 3.4% will simply not be enough to meet the rising demands on the NHS or ensure further development of services.
“Far more detail on training, public health and social care is essential as these critical areas impact so crucially on the ability of the NHS to deliver. These areas are not included in this announcement and that is a concern,” she said.
“After almost a decade of austerity, the NHS has a lot of catching up to do”
But Ian Dalton, chief executive of health service regulator NHS Improvement, said: “This settlement is good news for the NHS, those who use it and those who work for it.
“As we go into our 70th year, it will enable the dedicated staff in our NHS to go on improving the care we can offer the patients of this country with certainty and confidence,” he said.
He added: “We are determined to secure the maximum benefit for our patients from every new pound spent gained as part of this settlement. The NHS is already making significant productivity improvements and we will not let this vital work slip.”
Chris Hopson, chief executive of NHS Providers, which represents trusts, welcomed the extra funding, but said his organisation would now “want to see the details of the announcement”.
“After almost a decade of austerity, the NHS has a lot of catching up to do, just to deliver the standards of care the NHS constitution requires,” he said.
Mr Hopson noted that an average annual increase of 3.4% above inflation over the next five years was only slightly more than the 3.3% some experts thought was needed just to “maintain the current levels of service in the face of growing cost and demand”.
“So, we must be realistic about how far this funding, and productivity gains, will go – there will still be difficult choices to make about priorities,” he said. “We must also recognise that, without adequate support for social care, the NHS will always be held back.”
“It is deeply disappointing to see no further investment in social care in this settlement”
Commentators from the social care sector expressed similar concerns. Glen Garrod, president of the Association of Directors of Adult Social Services, said: “It is deeply disappointing to see no further investment in social care in this settlement.
“As has been remarked before, putting money into the NHS without putting it into social care is like pouring water down a sink with no plug in,” he said.
“As well as our doctors and nurses who do a phenomenal job, so too do our dedicated and skilled social care staff, who do everything they can to help older and disabled adults live as independently as possible without seeing the salary increases that NHS staff do,” he added.
Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, also said it was “hugely disappointing” that a “similar funding boost for social care and prevention services” had not been announced.
“Without essential council services, which help people live healthy lives in their own homes and communities, the NHS cannot thrive,” she said.