Rishi Sunak, the British chancellor, could not have been clearer in his first budget about the government’s commitment to helping the NHS play its central role in combating Covid-19. “Whatever extra resources our NHS needs to cope with Covid-19, it will get. Whatever it needs, whatever it costs, we stand behind our NHS,” he said.
The concrete expression of that pledge is the Covid-19 Response fund. The fund, from the Treasury, sets aside £5bn to help the NHS, local authorities, and others in the public sector needing to spend extra to keep important public services running as smoothly as possible.
It is hard to predict how much the virus will eventually cost those organisations but it seems likely that £5bn will not be enough. The Treasury made clear on Wednesday that the fund had been “initially set at £5bn” but that more would be forthcoming if required. “Any extra resources needed by the NHS will be provided as the situation develops. So it could go up, dependent on need,” said one Treasury official.
The detail of how much the different sectors might get, who will decide that distribution, and how the extra funding will be handed out will be set out “in due course”.
Organisations not usually slow to accuse ministers of underfunding the NHS, such as the Patients Association, welcomed the fund’s creation.
Saffron Cordery, deputy chief executive of NHS Providers, which represents trusts, said: “The additional £5bn is very welcome and we’re pleased to see this commitment to helping the NHS manage the coronavirus outbreak, and inevitably trusts are incurring significant additional costs.”
But Chaand Nagpaul, chair of the British Medical Association, was more guarded. “Whether this means millions or billions of pounds, this offer must come with no limits or catches.”
The virus could cause huge disruption to the NHS and lead to many deaths. Given that, it is vital every penny is spent in ways that will allow hospitals, GP surgeries, ambulance services and other key care facilities to help as many patients as they can in hospital but also at home, where more people will find themselves as beds are cleared to prioritise people with Covid-19.
John Appleby, chief economist at the Nuffield Trust, suggested that the NHS could use the £5bn to buy more personal protective equipment for staff (many doctors, and especially GPs, note worryingly short supplies in many places) and to cover the overtime that staff will rack up during the crisis.
NHS trusts could also use the money to pay the private sector to carry out some non-urgent operations, such as hip and knee replacements, hernia repairs and cataract removals, that they will almost certainly have to cancel, again to free up beds needed for people left seriously ill by the coronavirus.
But the NHS will spend most of its share on its most precious resource: its staff, who account for 70% of its budget. It could use the fund to pay the 18,000 final-year nursing students, whom Simon Steven, CEO of NHS England said on Wednesday would be drafted in to help boost the NHS workforce “when the worst came”.
The money will also help pay for the many shifts that agency and bank doctors and nurses will work as the service ensures it has enough personnel on duty.
Social care services will also seek a significant chunk of the £5bn. Already overstretched due to the ageing population and years of budget cuts, they will face extra responsibilities, especially in caring for older people discharged from hospitals. The money will help them pay for extra staff and overtime, and for beds in nursing homes for those whom it will not be safe to discharge straight home from hospital.