Health experts have called for investment in prevention and social care ahead of the spending review next week (11 June).
Various health experts have set out what they think should be prioritised in Chancellor Rachel Reeves’s spending review, including increasing the public health grant in order to boost spending on prevention and help reduce health inequalities.
This is the first multi-year spending review since 2021, according to the Institute of Fiscal Studies (IFS), who added that decisions over the NHS and defence will dominate.
The Health Foundation said this review was a ‘crucial moment’ for the government to signal the scale of its ambition to tackle health challenges.
It called for a boost in spending on prevention, including an increase in investment in the public health grant and better target allocations according to need.
‘Restoring the grant to the real-terms equivalent of 2015/16 levels per person and allocating it on an equitable basis would require an additional £3.6bn over the spending review period (2025/26 to 2028/29),’ it said.
It suggested that the review offered a chance to define prevention spending, as currently the budget does not distinguish between spending on acute and prevention.
It said: ‘Current fiscal frameworks do not distinguish between spending on acute services and prevention. Given the pressures on public finances, this risks prevention spending continuing to be squeezed.
‘The spending review offers a chance to strengthen the fiscal framework by defining prevention spending and developing ways to track it across government departments, with a focus on cost-effective approaches that prevent more costly acute need arising in the first place.
‘As an initial step, we recommend the Treasury establishes a review to make recommendations on how this could be done.’
The Health Foundation said to meet the needs of the population and to improve services, that NHS revenue budget would need to be at least £198bn by 2028/29.
‘This is based on the NHS achieving productivity gains of 1% per year from 2023/24 onwards – higher than the 0.7% per year long-term pre-pandemic average. Less funding – £190bn by 2028/29 – would be needed if the government’s productivity target of 2% per year were to be met,’ it said.
However, in addition to this, capital and day-to-day spending to digitise the NHS would need to be at £15bn over five years to achieve existing policies, the Health Foundation added.
NHS Confederation agreed that the investment in the public health grant should be a priority for the spending review.
It added that at least £3.3bn of extra investment was needed each year of the spending review period in order to tackle waiting lists and ‘build a 21ˢᵗ century health service’.
Rory Deighton, acute director at the NHS Confederation, said: ‘The most important decision the spending review will make for the NHS funding settlement is raising capital investment. NHS leaders have told us that this is a top priority and will be crucial for improving NHS performance, boosting productivity and reducing hospital waiting lists.
‘Decades of underinvestment have left the NHS with a £14bn backlog to maintain existing estate and not enough resources to invest in the facilitates, equipment and technology of the future. To tackle waiting lists and build a at least £3.3 billion of extra investment is needed in each year of the spending review period. This should in part be funded by greenlighting a new model of private investment, which learns from our own experience and those of other countries around the world.’
He added that spending should not just focus on NHS funding, but also social care and public health.
‘Beyond NHS spending, we agree with the Health Foundation that the public health grant and social care investment are crucial to a healthier future. NHS leaders know from bitter experience that protecting NHS funding while cutting other areas ends up costing more in the long run,’ he said.
‘Studies have shown that 80% of our health is shaped by factors such as education, employment and housing. But in recent years real terms cuts to local government funding for public health and social care have pushed up demand for healthcare and worsened NHS finances and waiting times. A mission-driven spending review needs to consider all these factors if the government wants the NHS back on its feet.’
It comes as the Government has committed to eliminating spending on agency staff in the NHS, which it called an ‘unnecessary cost’ to the service.
