The much-anticipated Autumn Statement given by the new Chancellor of the Exchequer, Jeremy Hunt, contained a great deal of information for businesses and individuals in terms of changes to the tax regime.
In addition to the tax changes, the Chancellor also made some important announcements about health and social care for England during his speech. Because health and social care policy are devolved areas of government, there are key differences between what Hunt announced for England compared to Wales, Scotland and Northern Ireland.
Given that the new Prime Minister had put an additional sum on National Insurance contributions during his tenure at the Treasury to pay for the then-PM’s demand for more funding in the social care sector, some commentators thought that there may have been a reversal of the previous U-turn on this policy made during Kwasi Kwarteng’s tenure as Chancellor. In the end, the Chancellor did not simply go back to the situation as it was planned under Boris Johnson’s premiership but came up with some of his own changes. Given that the governing party has had three prime ministers this year and no fewer than four chancellors – Sunak, Zahawi, Kwarteng and Hunt in the same period – many in the health and social care sector can be forgiven for not having been able to keep up.
That said, the key announcement for the care sector was that up to £8 billion more funding was set aside for health and care. According to the government’s own website, this figure will be pumped into the NHS and the adult social care sector in England, first becoming available during the 2024-2025 financial year. Perhaps understandably, the Treasury claimed that this sum – on top of current funding – constitutes a record budget for the NHS and adult social care in England. Although this may be true, the fact is that inflationary pressures in both sectors for things like fuel, food and even straightforward healthcare products mean that critics of the government – not least the official opposition benches – have said that the money will be insufficient to maintain care standards.
The day after the Chancellor’s announcement, the Department of Health and Social Care gave details of a major reform that would take place as a result of the new funding. Firstly, an independent review of integrated care systems – known as ICSs – would be set up with the aim of improving health outcomes across the entire country. Secondly, the former Labour Health Secretary Patricia Hewitt, who currently serves on the board of an NHS trust in Norfolk, had been appointed to run the new ICSs. The idea is to look at healthcare services across England alongside social care provision – as funded by private individuals and local authorities alike – to see how and where local leaders might be empowered to provide a more regionally-led focus on improving outcomes in their areas.
In response, Richard Meddings, Chair of NHS England, said that he thought it was “absolutely right” that the government was seeking innovative ways to ensure all the country’s health and social care systems are working as efficiently as possible notwithstanding the current economic challenges. Steve Barclay, the current Health and Social Care Secretary said that fewer top-down national targets, greater transparency and dropping a one-size-fits-all approach will help both sectors to operate in tandem with one another.
How this will affect private healthcare services is something that is – at the moment – anyone’s guess. Hewitt’s review is not expected for some time, after all. However, both the government and the opposition – as stated by the Shadow Health and Social Care Secretary, Wes Streeting – are committed to the continued use of private healthcare provision within the NHS. As for social care, the cap on private expenditure for adult social care set when Boris Johnson and Rishi Sunak were at numbers 10 and 11 Downing Street respectively, will remain.
This will mean that private home care services will still be able to be procured by people living in their own homes. However, social care funding will become available through local authorities after £86,000 has been spent on such services. This cap will come in from October 2023, as previously planned, good news according to one provider, Anglian Care, since it means people will be able to plan more effectively. Few commentators think that Hewitt’s review will be published before this date meaning that for the next year, at least, there should be some stability within the private social care sector.
