Autumn Budget 2018: Too little, too late?

Health, mental health and social care receive extra funding, but critics warn a longer-term solution is needed

Confirmation this week that the NHS will receive an extra £20.5billion a year, and a new commitment to dramatically boost mental health and social care services, have been dubbed ‘too little, too late’ by concerned critics.

In Chancellor, Philip Hammond’s Autumn Budget, unveiled yesterday, he claimed ‘the era of austerity is coming to an end’, confirming the extra cash announced by Prime Minister, Theresa May, earlier in the summer.

We are proud to have made this extraordinary commitment to funding our NHS

He also pledged an extra £2billion a year by 2023 for mental health services.

And local authorities in England will receive a further £650m social care funding next year.

However, the figures were called into question, with critics claiming the cash ‘fell short’ of what was needed and they have called for a much-more-long-term funding approach.

In his announcement Hammond revealed that:

  • The Government will increase its budget by £20.5billion after inflation by 2023-24
  • Within this cash, the NHS will increase mental health spending by more than £2billion a year by 2023-24
  • £10m of capital funding for ambulance trusts
  • Local authorities in England will receive a further £650m in social care funding next year
  • Scotland, Wales and Northern Ireland will all get more money to spend in devolved areas, including health

A full, detailed breakdown of how the money will be spent is expected ‘shortly’, Hammond said, adding: “We are proud to have made this extraordinary commitment to funding our NHS.”

At the time of year that the headlines are focused on winter pressures, it was good to hear the commitment to mental health, which has been a poor relation for a long time

On the extra cash for mental health service, which have long been neglected, he added: “There are many pressing demands on additional NHS funding, but few more pressing that those who suffer from mental illness.

“These new services will ensure that people suffering from a crisis, young or old, can get the help they need.”

Improvements to mental health services will include up to £250m a year for new crisis services, providing dedicated teams in A&E departments up and down the country. It will also fund:

  • 24/7 mental health support via NHS 111
  • Children and young people’s crisis teams in every part of the country
  • More mental health specialist ambulances
  • More community services, such as crisis cafes
  • Schools-based mental health support teams and specialist crisis teams for young people
  • Expanded access to the Individual Placement Support programme to help those with severe mental illness find and retain employment

Commenting on the impact of the budget, Jason Parker, UK head of healthcare of professional services firm, KPMG, said: “At the time of year that the headlines are focused on winter pressures, it was good to hear the commitment to mental health, which has been a poor relation for a long time.

“Investing in a mental health crisis centre and providing mental health support in A&Es could go a long way to creating the pro-active sustainable systems the NHS needs to transform itself into providing care at the point of need; instead of reacting when it’s too late.

“Likewise the additional funding for social care is extremely welcome – local authorities’ financial positions have been deteriorating at a pace for a long time, with many having to eat into reserves.”

But he warned that the investment would fail to make an impact unless the Government addressed problems with workforce and uptake of technology within the health and care sectors.

He said: “There are huge gaps in the NHS workforce as well as funding to bridge skill set gaps and training needs.

“This is particularly relevant as the NHS has also previously committed to significant spend on new technology.

“To make this investment, along with today’s announcement worthwhile, a radical reform is needed to the way change is implemented within the NHS; with areas like technology and social care for both the young and the old to be considered in conjunction instead of in silo as separate problems.”

And Richard Murray, director of policy at health think tank, The King’s Fund, said a one-year deal for social care was not enough and ‘falls far short’ of what is needed.

He added: “The social care system cannot continue to get by on last-minute, piecemeal funding announcements.

NHS mental health services have been underfunded for decades and we know that, too often, people don't get the help and support they need, when they need it

“Adult social care in England needs at least £1.5billion more a year simply to cope with demand, meaning that the funding announced today – which will also need to cover children's social care – falls far short.

“This highlights the need for a long-term plan for how social care will be funded and structured so that it can meet increasing demand.

On mental health funding, he added: “£2billion confirms the early signals that this would be a key priority for the forthcoming NHS long-term plan.

“But years of underfunding have taken their toll and this is no more than a small step on the road to parity of esteem.

“Mental health services need more than money to meet demand and a chronic shortage of mental health staff means that, despite the new funding, the service won’t improve until the Government and the NHS provide a plan to increase the workforce.”

Leading mental health charity, MIND, has also spoken out following Hammonds pledge.

Its chief executive, Paul Farmer, told BBH: “This budget was an important one for mental health.

Chancellor, Philip Hammond

“NHS mental health services have been underfunded for decades and we know that, too often, people don't get the help and support they need, when they need it.

“This commitment ahead of the NHS long-term plan indicates that mental health is rightly high on the Government's agenda, and has the potential to improve access to care, once detailed plans are clear.

But he said that the £2billion should be viewed as more of a ‘down-payment’ on what needs to be much-faster growth in future.

“One way to accelerate improvement is to make sure that mental health is a priority across the whole of the NHS, with significant investment in areas such as prevention, primary care and mental health support for people with long-term physical health conditions,” he said.

And British Medical Association (BMA) committee chairman, Dr Richard Vautrey, said GPs should also be a major focus moving forward, claiming the Budget had failed to properly finance the system to bring the necessary improvements to primary care services.

To make this investment, along with today’s announcement worthwhile, a radical reform is needed to the way change is implemented within the NHS

“The promised funding increases in this budget are unlikely to result in general practice reaching 11% of the NHS budget, which is what the BMA believes is needed to provide a fully-sustainable service.

“The investment in mental health services is welcome, but a similar figure needs to be directed directly into practices to deliver the focus the Government wants.

“Ministers must realise that more needs to be done, not least to address the difficult environment in general practice that is damaging patient care and putting GPs under intolerable pressure.”

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