On March 8, only four days after one of the largest national demonstrations opposing the government’s whole direction for the NHS the Chancellor of the Exchequer, Philip Hammond, concluded the last part of his spring budget speech on the NHS and elderly social care with the absurd claim: “Mr Deputy Speaker, we are the government of the NHS.”
Before this, the Chancellor had outlined the government’s values on the NHS when he said: “Just as the principle that every child should have the opportunity to fulfil his or her potential is central to the government’s values, so is the principle that everyone has access to our NHS when they need it. And that everyone should enjoy security and dignity in old age.” But while these words were aimed to try and comfort some MPs they were equally aimed to deceive. What was so striking about these opening comments on the government values towards the NHS and elderly social care was that the commitment that access health care “free at the point of use”, so regularly mentioned in previous value statements of government Ministers, was completely omitted by the Chancellor. And such concerns were further justified when he announced that, although the government was to “commit additional grant funding” to councils for social care over three years, the long-term plan for social care was that “the government will set out its thinking on the options for the future financing of social care in a Green Paper later this year”.
The Chancellor did outline some of the disastrous consequences of the present direction for the NHS and social care for the elderly, and he admitted that the “system is clearly under pressure”, but of course he did not refer to the true scale of the crisis that has today brought the NHS and social care to the brink of disaster. He claimed to be dealing with the short to medium term problems by “committing additional grant funding of £2 billion to social care in England over the next 3 years, with £1 billion available in 2017-18”. But as one listened to this, there was no sense of belief in these remarks that such funding would actually be delivered as real funding; in fact, the opposite was revealed to be the case. Nor was there any ongoing plan or commitment to the NHS and social care other than the continued cuts, privatisation and further passing of paying for health and social care onto the people. The tone of the whole budget was of further paying the rich in the name of “building a stronger, fairer, better Britain”.
This theme continued when he spoke about the “NHS 5 Year Forward View” and the “Sustainability & Transformation Plans” (STPs). He said that “we recognise, too, that in addition to the funding already committed, some of those plans will require further capital investment. So the Treasury will work closely with the Department of Health over the course of the summer as the STPs are progressed and prioritised. And at the Autumn Budget I will announce a multi-year capital programme to support implementation of approved high quality STPs.” He also indicated that Health Secretary Jeremy Hunt expected that “a small number of the strongest STPs” may be ready ahead of the Autumn Budget. Hammond said he would therefore allocate an additional £325m to allow the first selected plans to proceed. However, what was striking was his refusal to acknowledge that this neither addressed the massive cuts in funding that these STPs represent if they go ahead, nor the disastrous direction that they are taking the NHS, closing further already overstretched acute services, A&Es and hospitals. For example, the average annual cut to funding of the 44 STP foot prints is in the region of £500 million for each STP and overall with almost a third of the NHS budget – over £22 billion. In other words, what Hammond was talking about was not additional funds for the STPs but funds that will be top-sliced from massive NHS budget cuts!
It is important that, in reviewing this budget, the people recognise that only a pro-social government that directly represents the right to health care can be “the government of the NHS”. This requires reversing the whole anti-social direction in health and social care as well as mental health care. It requires the establishment of proper public authority over public services which are accountable to the people and those that work in the NHS. Such a government must recognise that access to health care is a right of everyone in a modern society, and that this right must be guaranteed for all regardless of their status but simply because they are human. It would be incumbent on such a government treasury and any Chancellor to make the necessary claims on the economy to meet the needs of the NHS and social care system in full. The people must demand that no budget can be regarded as legitimate unless it ensures that public right prevails and the duty of government to provide a comprehensive acute, community, physical and mental health and social care service across all communities is restored.