Sajid Javid, who has been Secretary of State for Health and Social Care since June 2021,used a speech at the Royal College of Physicians in London to emphasise his credentials as a “small-state conservative” and said a greater focus on disease prevention, personally-tailored budgets and digital technology would help to ensure healthcare remained affordable.
Health spending accounted for 27% of day-to-day public service spending at the start of the century and will rise to 44% by 2024, an acceleration of a trend “in which the composition of the state has shifted towards health and care over the last 70 years”, he said. Javid, who was Home Secretary from 2018 to 2019, Chancellor of the Exchequer from 2019 to 2020, and has been a Member of Parliament for Bromsgrove since 2010, said that his experience was based on leading six government departments – including the Treasury and now heading “the highest spending department” – as he outlined the consequences of the health budget on the rest of Whitehall. “I’ve seen first-hand how — when healthcare takes up an ever-greater share of national income — you have to make some serious trade-offs on everything from education to infrastructure,” he said, and suggested the solution was “becoming much more efficient in what we do”.
The First NHS Pamphlet that Landed on People’s Doorsteps Back in July 1948
Sajid Javid said of the new health service: “It’s not a charity. You’re paying for it, mainly as taxpayers”. This year, the NHS will spend its original 1948 budget, adjusted for inflation once every month. The UK health budget is now bigger than the GDP of Greece. He added “I’ve seen first-hand how – when healthcare takes up an ever-greater share of national income, you have to make some serious trade-offs on everything from education to infrastructure”.
Javid elaborated: “Our current target is for 200,000 people to have a personal health budget by 2024, but I want to see a significant expansion in the coming years. We will start by exploring the extension of legal rights to enable significantly more people to benefit. I also want more people to have integrated health and social care budgets to better join up care for individuals. The NHS is already becoming a more personalised service with personalised budgets, personalised technology, personalised medicine and treatment. I want to see a radical acceleration of that process. By 2030, I intend for personalisation to become the norm and personal health budgets to be an increasing part of that. Taken together, I intend for this to be one of the biggest transfers of power and funding in decades: from the state, to the individual and their family. We must keep this spirit on our road to recovery. We all have faith in the NHS, not just because of what it can do for us, but also what it stands for: the ideal that we each have a responsibility for the health of our fellow citizen.”
The New Conservative Government Plans for the NHS Are Long-Term
Published in January 2019, the funding plans are based on announcements made back in 2018. Announcements on hospital building and infrastructure spending were made more recently, plus a small additional amount of money in order to help provide more GP appointments. Overall, the funding announced for the NHS from 2018-19 to 2023-24 amounts to a rise of £20.5 billion in real-terms, or 3.3% per year. The £20.5bn was announced by Theresa May back in the summer of 2018 to mark the 70th birthday of the NHS.
Conservative Plans for NHS on their Website
The Conservative Party indicates on this website that: “We’re making sure the NHS has the resources it needs so that it can provide everyone with the best possible care. The NHS budget will go up by £33.9 billion by 2023-24. That’s the biggest cash boost in its history. And we’re making sure that money is already getting to the frontline with £6.2 billion more this year.” They also talk about building infrastructure: “On top of more money for the NHS every year, we’re investing in hospitals so that our brilliant doctors and nurses have the facilities they need to give patients the best possible care. We’re providing £850 million for 20 hospital upgrades, £2.7 billion for the first six new hospitals, and seed funding so that work on 34 more can make progress. And 78 hospital trusts will receive state-of-the-art MRI, CT and mammography screening machines, so cancer can be detected more quickly to boost survival rates.”
Department for Health and Social Care Budget Provides Funding for Health Services in England
Planned spending for the Department of Health and Social Care in England is £190.3 billion in 2021-22. The majority of the Department’s spending (£136.1 billion in 2021-22) is passed to NHS England and NHS Improvement for spending on health services. The remainder is allocated to other national bodies for spending on other health-related functions such as public health (including grants to local authorities), training and development of NHS staff, and regulating the quality of care. The Department’s spending in 2021-22 includes £33.8 billion to respond to the Covid-19 pandemic – this includes procuring personal protective equipment for staff, the vaccine and Test and Trace programmes, and improving the discharge process for hospital patients. Together with additional funding for delivering the government’s manifesto commitments, the Covid-19 spending means the Department’s budget grows rapidly between 2019-20 and 2022-23 before leveling-off in future years.
In response to the Secretary of State’s speech, Andrew Goddard, president of the Royal College of Physicians, said: “The Secretary of State’s focus on preventing ill health is welcome. He is right to say that the health of the population and the health of the economy go hand in hand and that this means reducing health inequalities. We eagerly await the disparities white paper and how the Health Promotion Taskforce will achieve this. However, change of the kind the Secretary of State advocates requires planning, particularly when it comes the size and nature of the NHS and social care workforce. The Secretary of State’s acknowledgement that there will be no additional funding to support this brings clarity but this will undoubtedly make the challenge all the greater.”
Contractionary policies for the health economy due to the heavy pressures of Covid-19 as an additional and overwhelming cost, the reduction of government revenues due to the pandemic and the energy crises are all factors that make it harder to allocate budget to the NHS. Considering Conservative promises in the recent election about supporting the NHS and comparing it with reality makes the current condition unpleasant for them.