NHS England to get spending boost sooner than expected

NHS England won’t have to wait five years for money promised by the Government after its chief executive won a vital battle with the Chancellor just 24 hours before the Spending Review.

In one of the last departmental settlements to be agreed, George Osborne finally met Simon Steven’s demand to start paying out now some of the £8 billion pledged by 2020.

Mr Stevens said: “This settlement is a clear and highly welcome acceptance of our argument for frontloaded NHS investment. It will help stabilise current pressures on hospitals, GPs, and mental health services.”

It is no coincidence the Treasury has chosen to publicise its decision with 36 hours still to go before the Chancellor takes to the Despatch Box.

With junior doctors strikes looming next month and NHS providers forecasting an end of year deficit of over £2bn, this is one bit of health news the Chancellor doesn’t want to get lost among the tax credit headlines bound to dominate on Wednesday.

Describing the deal as “unprecedented investment in the NHS”, Mr Osborne said: “It’s only because we have taken the difficult decisions needed to cut the deficit and are delivering economic security that we are able to commit an additional £10 billion a year by 2020 to the NHS.

“We will deliver £6 billion a year extra investment straight away, as those in charge of the NHS have requested. This means I am providing the health department with a half a trillion pound settlement - the biggest ever commitment to the NHS since its creation.”

Delivering investment now is vital. The NHS is in desperate need of breathing space to look up from its current problems and start making the changes needed to help an ageing population and more patients with long-term conditions.

Health Secretary Jeremy Hunt said: “This upfront investment means we can implement the NHS's own ambitious plan to transform services for the future.

"We are passionate about building an NHS that offers the safest, highest quality care anywhere in the world - with services smoothly operating seven days a week. This new money will help us finish the job.”

But this isn't new money and the much-trumpeted figures aren’t quite as clear as they could be.

We have known since the Tories took office in April that they planned to meet their manifesto pledge of an extra £8bn for the health service. Along with a very tough £22bn of NHS savings, that should deliver the £30bn Simon Stevens said he needed to deliver his Five Year Forward Vision.

But doctors have repeatedly pointed out that total doesn’t include any extra funding to deliver the seven-day NHS pledge since added on by the Government.

Remember, as a percentage of our gross domestic product we are witnessing a sustained fall in NHS spending somewhat at odds with the government rhetoric.

And its my understanding even the £6bn a year described by the Chancellor as “extra investment” includes the £1.8bn given to the NHS to get it through the crisis last winter.

The actual breakdown will see £3.8bn being made available in 2016/17, with a further £1.5bn the following year.

Still, Tuesday's announcement does show a Chancellor making good on commitments he’s already made. In the toughest of economic climates that shouldn’t be underestimated, given the hefty savings being made elsewhere.

The Institute for Fiscal Studies estimates departments that haven’t been given the kind of special protection bestowed on the NHS face cuts of 27%.

But with local council budgets responsible for funding elderly care among those waiting for the axe to fall, there is a real danger the NHS will be looked after while social care is left behind.

And that has a real impact on what hospitals can and can’t deliver to their acute patients. Already beds are increasingly filled with patients who would much rather be at home – if only there was community care available.

Funding for anti-obesity and smoking cessation schemes may also be hit, again with consequences for demand on our hospitals.

Anita Charlesworth, chief economist at the Health Foundation think tank, said: “It is essential that any additional funding for the NHS is not at the expense of public health. Robbing Peter to pay Paul would be a false economy.”

With Accident and Emergency targets unmet for a year and delayed discharges at record levels, its arguable the Chancellor had to do something for an NHS deeply in the red. But there will still be plenty to listen out for when he takes to the Despatch Box on Wednesday.