United Kingdom. What fate for the NHS with the new premier Sunak? No spending cuts but a spending review

by Grace Labate

The new prime minister assured that the NHS has a “particular interest” in its programs especially after the pandemic and in view of the arrival of a problematic winter. Health spending should therefore not be cut, but Jeremy Hunt, the current chancellor and former health minister, said the government expects the NHS and the Department of Health and Social Care to do a very detailed analysis for overcome all the inefficiencies that still exist

04 NOV – The toilet of Rishi Sunak devotes a “particular interest” to the NHS because the Prime Minister is aware that the national health service that comes out after Covid faces a “challenging winter”.

Healthcare spending will not be cut, but he explains to ministers that a reform program is needed for underperforming trusts. Jeremy Huntthe chancellor and former health minister, said the government expects the NHS and the Department of Health and Social Care to do a very detailed analysis to overcome any inefficiencies that still exist.

The cabinet discussion on the NHS saw PM Rishi Sunak alert that the health service is facing a “very challenging winter”, praised progress in recruiting 30,000 new nurses and the introduction of community diagnostic centers , useful for not flooding hospital emergency rooms, but the NHS is faced with a shortage of doctors which appears to be the underlying structural problem for its optimal functioning.

Steve Barclay, the health minister, told his fellow cabinet ministers that citizens expect a strong improvement in the NHS, after the sad events of Covid which cannot be disregarded. Long waiting lists, clogged emergency rooms can no longer be tolerated.

The prime minister said the government would always support the NHS and that it would continue to be prioritized as spending decisions were made.

He also said that further ways should be sought to improve the service the public receives, and he was confident that this goal could be achieved.

When asked if the health budget will be protected, he added: “I will not go into the individual budgets of the ministries, but health care is a priority, even when difficult decisions are made on the spending side”.

Sunak also resisted cutting the number of civil servants, saying that the goal of reducing them has been abolished.

However, he warned in a letter to civil servants that every government department will be told “to look for the most effective ways to deliver value and maximize efficiency within budgets” so that taxpayer money can be used “sustainably and in the long term”.

Amid warnings that the UK is likely to face years of tax increases to close the £50bn tax hole, the Treasury is set to extend the four-year freeze on tax cuts and personal thresholds, which will put the people into new tax brackets and which will bring in around £5bn a year if extended until the end of the 2020s.

A senior government source said such “fiscal resistance” would likely be the “guiding principle” behind raising taxes across the board.

The chancellor is believed to be planning a tax proposal that balances spending cuts and tax hikes fifty, fifty, including a potential windfall tax expansion on oil and gas companies.

Under George Osborne, the Treasury has been working with an 80/20 formula of cuts and new taxes. Now you would like a 50/50 setting.

Other tax-raising measures under consideration include a “bolstered tax,” increasing the amount paid or extending the tax through 2028. Another option on the table is to target some more politically palatable personal tax increases, such as cutting of tax relief for higher pensions.

Although Sunak has previously increased National Insurance to pay for NHS and welfare reforms, MPs have voted to scrap the £12bn increase planned during the short-lived government of Liz Truss. Government sources say reinstating the hike remains under study, along with all other fiscal measures. Despite plans not to cut health spending, the NHS is already assessing the cuts it will need to make to plug an estimated £7bn hole in its budget next year due to inflation

Julian Kellythe NHS finance chief, warned last month that he would “have to completely revisit investment in cancer, mental health, primary care and diagnostic services” unless the Treasury increases its health budget.

In a private briefing for senior medical colleagues, the usually unflappable Amanda Pritchard, chief executive of NHS England, has been very somber about the financial situation facing the service and told them ‘money is a fucking nightmare’.

The extra financial commitments the health service will face come on top of the £12bn of “efficiency savings” it has already agreed to make between this year and 2024-25. So if it is true that Prime Minister Sunak wants to defend the NHS and as he says in a challenging winter for the health of the British, he just has to find new resources for the NHS, which, with the same efficiency, improve the quality of the service provided to citizens who appear already today quite exasperated.

Grace Labate
Researcher in health economics, former undersecretary of health

04 November 2022
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