Jeremy Hunt has done it before. When he was health secretary, funding for the NHS was inadequate and he did not set up a long-term plan for the required workforce expansion. Hunt came to regret it and in 2021 admitted that “I was too slow to boost the NHS workforce – the government must, and can, act now”.
However, in his new capacity as chancellor, Hunt has failed the NHS for a second time with his mini-budget announcement on 17 November. Although the NHS and social care will not suffer from the same real-terms cuts as other areas of public spending, adequate resources have not been provided for the NHS rising costs and there is no plan yet for the workforce expansion.
Fair and adequate pay
Patient care is going to get worse with the expected strikes by nurses, junior doctors, and ambulance staff. The public does not want a health secretary who refuses to negotiate with the nurses, as Steve Barclay has done, and we do not need ‘anti-union’ laws.
Many workers have a genuine grievance. With the two measures of inflation (Consumer Price Index and Retail Price Index) at 11.1% and 14.2% respectively in October 2022, pay offers in the region of 5% are neither fair nor adequate.
Martin Wolf in the Financial Times explains that public sector pay has lagged behind the private sector in the last two years by about 6.2% and neither group of workers has benefited from the inflation-matched rises granted to those in receipt of either state pensions or some other pension schemes.
Whilst it may not be realistic to offer pay rises that precisely match inflation, engagement with the unions and fairer offers are more likely to bring about an end to disruptive and damaging industrial action. Scotland’s pay offer of about 7.5%, with higher increases for low earners, seems to have been well-received by the health unions.
The government has exaggerated what would be the cost of fairer pay deals. A revised budget would be required with some tax adjustments, but without better pay, we cannot start filling the many vacancies in either the health or the social care sectors.
During the 2019 general election both the LibDems and Labour proposed some increase in taxation to better fund the public services. The need for higher taxes has increased as a consequence of the Covid pandemic and Liz Truss’s disastrous mini budget.
At times like this, when an increase in public spending is required, the tax revenue lost because of Boris Johnson’s damaging hard Brexit is sorely missed.
Brexit has shrunk the UK economy by about 4% according to the Office for Budget Responsibility. Exports to the EU have been particularly affected, with a 23% reduction. Farming will be further damaged by the post-Brexit trade deals with Australia and New Zealand, something that even the Conservative MP George Eustice, environment secretary under Johnson, is ready to admit.
Brexit has also exacerbated inflation, causing a 6% increase in food prices, according to a report by the London School of Economics.
The NHS on its knees
The NHS is currently on its knees with increasing waiting times for ambulances and at emergency department, longer waiting times for elective procedures, and inadequate maternity services. This is mostly driven by inadequate staff numbers in the NHS and in social care: the number of NHS vacancies is at an all-time high.
A failing NHS will also damage the economy. With pension age increasing we need a healthier population. The recent rise in the number of working age people who are ‘economically inactive’ (neither at work nor seeking work) seems to be due in part to poor health.
Hunt is letting down the NHS for a second time. To some extent he is constrained by the right-wing faction which has dominated the Conservative Party since Brexit.
Underfunding of fair pay deals and of public services will not serve our nation well.