The 2018 Budget was delivered by the Rt Hon Philip Hammond MP on 29 October. Details regarding the National Health Service (NHS) included a reminder of the five year deal announced in June 2018 investing £83.6 billion into the NHS, for which the NHS is required to produce a ten-year plan for reforms. The Budget also stated that more importance would be placed on mental health services, children and young people, assistance with employment in those with a severe mental illness, and additional funding for air ambulance trusts.
Responses to the Budget have now been given by NHS leaders and the UK life sciences sector. The chief executive of the Association of the British Pharmaceutical Industry (ABPI) welcomed the additional funding confirmed for the NHS and to support businesses, including pharmaceutical companies, in the event of a ‘no deal’ Brexit.
The UK BioIndustry Association (BIA) has produced a comprehensive report on the aspects of the Budget that could impact on BIA members. As with the ABPI response, these included the confirmed additional funding for the NHS and Brexit. Other favourable aspects of interest included the government pooling UK pension schemes for long-term investment in patient capital and the addition of another £1.1 billion for the Industrial Strategy Challenge Fund (ISCF), which supports research and innovation. Less favourable aspects included the reintroduction from 2020 of restrictions that had previously been imposed on research and development tax credits, although the report does acknowledge the cap would be three times higher than it was before.
NHS leaders were all broadly in agreement in welcoming the extra money, but with warnings over the amount being insufficient.
Niall Dickson, Chief Executive of the NHS Confederation, welcomed the confirmation of extra money but cautioned,
“…let no-one be in any doubt about the challenge ahead – rising demand, a monumental workforce crisis and an urgent need to change the way services are delivered will make the next few years very tough indeed.”
He continued with a warning that the extra funding for the NHS is inadequate for the required improvements to the social care system by stating,
“…the extra funding announced today – again welcome – is clearly inadequate. What we needed was support to get the system back on its feet but what we have is yet another sticking plaster. This means we will struggle on for another year. We hope that the social care green paper is not further delayed: this has huge implications for both health and social care and most importantly for the people who need these crucial services.”
Julie Wood, Chief Executive of NHS Clinical Commissioners, also appreciated the confirmation of extra money but highlighted that the amount budgeted still means the Clinical Commissioning Groups (CCGs) will need to make difficult decisions to get the best value from it stating,
“CCGs will continue doing their utmost to improve the health of their populations, but can only do this within the funding they are allocated. We look forward to the long term plan, and working together to foster further integration. This can help CCGs overcome some of the barriers they’re facing and make even better use of the limited NHS pound.”
In agreement with Niall Dickson she mentioned she was hoping to see more funding for social care from the green paper and the 2019/20 spending review. She welcomed the focus on mental health crisis care, which included many initiatives requested by the Clinical Commissioners, but remained concerned over a lack of funding to help strengthen core mental health services. Similarly, Sean Duggan, the Chief Executive of the Mental Health Network of the NHS confederation, also welcomed the funding but with a warning of:
“The scale of the challenge the [mental health] sector faces cannot be underestimated. Last week’s report from the IPPR concludes that a five per cent annual increase in the mental health budget is absolutely necessary in order to achieve true parity with physical health. It is positive to see that specialist crisis teams for children and younger people will be set up in every part of the country as we know how important it is to address mental illness as early as possible. However, we must keep our eyes on the immediate needs of our core inpatient and community mental health services, and we must also remember that social care, capital budgets and public health will need additional funding.”
Rachel Power, Chief Executive of the Patients Association, has claimed the Budget has not clarified to patients how the health and care system will have the resources it needs, stating:
“We already knew that he had committed to five more years of below-trend growth in the NHS’s funding. But we had not yet heard what the equivalent settlement would be for vital NHS functions outside the so-called ‘front line’ ring fence, such as public health, workforce training and capital investment… We now know that essential NHS functions supposedly not part of the ‘front line’ will get no new funding ahead of the 2019 spending review, when the NHS will have to make its case. In the meantime, those budgets will be falling yet again for next year. This will make it much harder to reverse ongoing slippages in the NHS’s service standards.”
The response from the ABPI is available here.
The report by the UK BioIndustry Association is available here.
More details on the NHS leaders’ response to the Budget is available here.
The response from the Patients Association is available here.