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That Spending Review funding ‘increase’ for the NHS is not all it’s cracked up to be

On Wednesday 11 June, chancellor Rachel Reeves announced the details of the Labour Party government’s latest Spending Review. Corporate media pundits and politicians alike have been hammering the observation that the NHS took the ‘lion’s share’ of the new funding.

Notably, Reeves proclaimed the government’s “record cash investment” for day-to-day NHS spending of £29bn. She boasted in typical three-word political slogan that this would mean:

More appointments. More Doctors. More Scanners.

However, the commentary from the billionaire press and Westminster political classes missed a key point. This is the fact that, when you dig into it, the so-called spending increase is not really an increase at all.

What’s more, who profits from the new funding was glaringly absent from the discourse. Of course, that would be the private sector – all while Labour’s promises to improve the state of the NHS will likely fall flat. As ever then, it’s the public that will continue to lose out thanks to Labour’s austerity and neoliberal ideological agenda.

Spending Review: More funding to the NHS?

Self-aggrandizing Labour MPs and supporters showered praise on Reeves’ supposed cash uplift for the key public service. This included Reeves’ sister and Labour MP for Lewisham West and East Dulwich Ellie Reeves:

Health secretary Wes Streeting is never one to miss the chance to toot his own horn:

Meanwhile, some corporate media talking heads – like Sky’s Beth Rigby – were more critical:

Of course, this is a false dichotomy. Labour can put more money into the NHS AND other budgets. Labour is making a political choice not to increase spending for other public services and departments. Campaigners have pointed out repeatedly that if Labour levied a modest 2% annual tax on assets over £10m, it could generate £24bn a year. In other words, the problem isn’t in the lack of Treasury revenue, but in the lack of political will to tackle gross inequality.

Instead, loathe to lay the costs on its wealthy donors and capitalist connections, the Labour government has been on a budget-cutting warpath against the most marginalised communities.

What does the Spending Review say about the NHS?

For the NHS, the Spending Review put forward the following:

  • The NHS in England will get a real-terms annual £29bn funding increase, equating to 3% growth in “day-to-day spending”.
  • Real-terms increase of £2.3bn between 2029-2030 for the DHSC.
  • £10bn for NHS technology and its digital transformation plans.
  • £30bn over the next five years for maintenance and repair of the NHS estate.

The cash injection to operational spending will take the NHS day-to-day budget up to £226bn by 2028-29.

As a result of all this, the government claims this will enable it to cut waiting times to meet statutory targets. Specifically, this sets out that the NHS will see 92% of patients for treatment within 18 weeks of referral for non-emergency care. The SR points out that currently, this sits at less than 60% of patients. It also notes that waiting lists since Labour took power have remained stubbornly high at 7.4 million.

It also promises that this will help it deliver:

  • Training and recruiting “thousands more” GPs – though it doesn’t set a specific target.
  • 700,000 more urgent dentist appointments over the SR period.
  • Employing 8,500 more mental health staff by the end of Parliament.

It’s not all as it seems

Health and social care think tank the Nuffield Trust has called out the glaring cons in the so-called Spending Review increase.

For one, it fails to make up for more than a decade of Tory austerity. The period between 2011 and 2024 saw a pitiful 2.4% average budget increase that the new spending fails to address.

Moreover, it highlighted how Labour’s 3% supposed increase is still less than the historic long-term trend between 1979 and 2020 of 3.7%. This also means the annual health spending is less than under previous Labour governments.

In short, after years of chronic underinvestment, the ‘increase’ won’t be enough to keep pace with growing costs and demand.

In reality though, it can hardly be called an increase.

Nuffield Trust senior policy analyst Sally Gainsbury pointed out how when you factor in rising costs to the NHS, the funding from the Autumn budget has already been “more than wiped out”. This includes rising expenses on everything from inflation to a growing, ageing population, and planned expansions in elective care capacity to drive down wait times that Labour is promising. Gainsbury extended this to the funding Reeves announced in the SR:

Compared to the settlements for other departments – from policing to education – the NHS deal looks generous. But seen in the context of all the promises made by the government to the British people – to drive down waiting lists, shift care closer to home, rapidly improve tech – and the commitments to meet staff pay demands and rising costs of new drugs, today’s settlement soon melts away.

The NHS is not in a vacuum

What’s more, Labour’s stagnant Spending Review funding, and cuts in some areas, will only worsen the health of marginalised communities. Gainsbury underscored the lack of social housing commitments as one area the government is failing to deliver, and putting people’s health at risk due to homelessness and atrocious temporary housing. She also hinted at the impact of the Department for Work and Pensions (DWP) callous and devastating cuts. Gutting the welfare system for chronically ill and disabled communities is set to push hundreds of thousands, if not millions, into state-sanctioned poverty.

In short, real-terms spending cuts is putting the health – and lives – of poor, chronically ill and disabled communities at risk. In turn, their deteriorating health means they’ll need expanded care – but Labour’s new NHS funding won’t keep pace with this.

There were other issues too. These included:

  • Capital funding is staying flat in real-terms. This means there’s a severe lack of investment for repairs and upgrades to the NHS’s crumbling estate. In October, NHS England estimated that it has a maintenance backlog of £13.8bn.
  • Social care funding is flatlining. The SR promises £4bn in 2028/29 for adult social care. However, the Health Foundation has previously calculated that the social care budget needs £6.4bn for that period. This is required to meet rising costs, demand, and improve access.
  • Big Pharma driving up the cost of drugs will also eat into this funding. Labour Party MPs – including key ministers like the chancellor and health secretary Wes Streeting – have taken sizeable donations from the sector and its lobbyists.

Waiting list promises not enough

What’s more, Labour’s pledge to cut waiting list targets doesn’t stand up to scrutiny.

Even supposing its funding ‘increase’ drives down treatment waiting lists for non-urgent treatment, there’s nothing in the SR to match for initial outpatient appointments. Notably, the figures the SR is referring to concern waiting times for treatment, so don’t take into account the length of time patients wait to see a specialist consultant in the first place.

The NHS doesn’t publish centralised data for this. So the Canary has brought together wait times for first out-patient appointments for services across England to get a sense of the broader picture. The graph below demonstrates the wait times for first appointments in a number of specialisms at nine separate NHS trusts:

Waits for these initial consultations can be as long as 26 weeks in some cases. It’s typically only after these first outpatient appointments that consultants will refer patients on for treatment.

Therefore, it means that while patients could see wait times drop for treatment referrals, getting these in the first place could still take many months.

In short, Labour’s SR is focusing solely on bringing down treatment wait times. But it’s ignoring the need to also set targets for bringing down these first outpatient appointment wait times in tandem. It means patients could still face astronomical waits for the care and diagnosis they need.

Privatisation: the missing puzzle piece with the Spending Review

All of this is to ignore where Labour will likely funnel this new funding to the NHS. And that’s straight into the corporate coffers of the private sector.

Of course, there’s no word on how much of the new spending will go to private healthcare companies in the review itself. However, Labour has made repeated platitudes to increasing the role of the private healthcare sector. So, it logically follows that’s where it plans to direct at least some – if not the vast majority – of this new funding.

We already know the government is courting big AI tech firms to take control of NHS patient data. Incidentally, these have been lobbying Labour ministers as well. Will it be these parasitic corporations that will be clamouring for a slice of that £10bn NHS technology profit pie? It seems highly likely.

Campaign group EveryDoctor’s Julia Patterson told the Canary of the Spending Review:

This Labour government came to power promising the public that they would rebuild the NHS. This is so important, because the service is in a state of absolute emergency. Millions of patients cannot access timely healthcare in the NHS, and the staff morale is extremely low.

This has not happened by accident- it has happened because of intentional political decisions over the past 15 years to starve the service of resources, and privatise areas of the NHS too. The funding announced by Rachel Reeves represents a *lower* real terms increase of funding for the NHS than the average of the previous decades.

This is unacceptable, and the public deserves better than this. Every single patient deserves to be safe in the NHS, and every single staff member deserves to be properly supported to do their important work. This Labour government should stick to its promises and commit more funding to the NHS immediately.

Overall, Labour’s Spending Review was more grandiose warm words than anything with actual substance. When it comes down to it, the funding commitments will mean little for the public’s health. The private sector on the other hand, will likely soon be reaping the rewards.

Featured image via the Canary

By Hannah Sharland

This post was originally published on Canary.