Philip Hammond responded to the growing crisis in social care in England by pledging to put £2bn extra into it over the next three years and also produced an unexpected £425m to help the NHS cope better with winter and transform how it works.
Additional money for social care was necessary both to improve the help older people receive as the number of over-75s grows quickly in the coming years and also to ease the huge pressures the NHS is under, the chancellor said in his statement.
He also promised that a green paper, due late this year, would set out options for resolving the financially and politically pressing question of how to fund social care in the long term, given the population is set to continue ageing.
The cash boost, £1bn of which councils will receive to use in 2017-18, follows dramatic warnings from charities, health organisations and the care regulator that England’s social care system is reaching “a tipping point” after years of budget cuts.
“Today, our social care system cares for over a million people and I pay tribute to the hundreds of thousands of carers who work in it. But the system is clearly under pressure. And this in turn puts pressure on our NHS,” Hammond told MPs.
“Today there are half a million more people aged over 75 than there were in 2010 and there will be 2 million more in 10 years’ time. Today I am committing additional grant funding of £2bn to social care in England over the next three years, with £1bn available in 17/18.”
Hammond made clear that he expected “local authorities to act now to commission new care packages” for the coming financial year. Those would enable mainly frail, elderly people to be better supported in order to keep living safely at home and also, in particular, help reduce the number of older patients trapped in hospital – sometimes for many months – despite being medically fit to leave, because social care in their area is inadequate.
The £2bn was significant because Hammond had rejected widespread cross-party appeals for a cash injection for social care ahead of both his autumn statement last November and the local government finance settlement a few weeks later.
But health, social care and older people’s organisations gave the £2bn a lukewarm response. It was much less than was needed to ensure all older people got the care they needed, they said.
“Although we warmly support the chancellor’s announcement of a social care green paper in the autumn, this is tempered by some anxiety that today’s emergency funding package, welcome though it is, may not be enough to keep the system going until a new, sustainable approach is put in place,” said Caroline Abrahams, Age UK’s charity director.
Experts’ recent estimates of the amount needed between now and 2020, after six years of Whitehall cuts to town hall budgets, “were all higher than the amount announced today”, she said. “We also need to know more about where the additional £2bn is coming from and whether it is genuinely new money or not,” she added.
“Our concern is that there could be big trouble ahead in some places for older people needing care and their families if providers continue to shut up shop and councils find it impossible to spread the jam any thinner to meet rising demand.”
Nigel Edwards, chief executive of the Nuffield Trust health thinktank, said the £1bn would plug only half of the £2bn funding gap it expected in 2017-18. “More and more vulnerable people are therefore going to be denied the help they need in the next year,” he said.
Doctors welcomed Hammond’s announcement of £100m to pay for more GPs to work at hospitals in order to help take the pressure off A&E units by triaging and treating less seriously ill patients. Expanding such schemes, which already operate at some hospitals, would help the NHS cope better with next winter, the chancellor said.
“Having primary care on site will undoubtedly benefit patients,” said Dr Chris Moulton, vice-president of the Royal College of Emergency Medicine, which represents A&E doctors. But the British Medical Association and NHS Providers said they doubted there were enough GPs to staff such services, given the chronic lack of family doctors.
Hammond also found £325m of extra money for the NHS’s capital budget to help turn the first batch of NHS England’s controversial sustainability and transformation plans (STPs) into reality. It will enable six to 10 “pioneer” STPs, which the NHS chief executive, Simon Stevens, will identify later this month, to go ahead, shaking up how care is delivered in their area, particularly by providing many more services outside of hospitals.
However, the £325m comes after Jeremy Hunt moved £1.2bn of the NHS’s capital budget into its revenue budget this year, in order to help struggling hospitals. He plans an identical £1bn switch in 2017-18 and, the Health Service Journal disclosed on Wednesday, further raids of £500m and £250m in the two years after that.
