From striver alert to future cuts: five things to expect from the Autumn Statement

A few insights from Gavin Kelly to help you navigate Osborne's fiscal arithmetic.

In the Autumn Statement there will be a blizzard of facts, figures, assertions and counter-assertions. There have been a few helpful pointers on what lto ook out for (try this and this), and I’ve already given my tuppence worth on what may happen to the faltering fiscal rules. But here are a few further insights to bear in mind.

First, be on striver alert. Expect plenty of warm words about "do-ers and grafters" who get up and work hard on modest means. In a different part of the Chancellor’s speech there will be tough messages and measures for those working age families who receive tax credits and benefits. Not for the first or last time the impression will be given that these are two distinct groups inhabiting different moral and economic worlds. They aren’t. Three quarters of tax credits go to working households. If reports about capping tax credit increases at 1 per cent are correct then so-called strivers are about to be squeezed too. 

Second, there will be new news on wages – and the longevity of the squeeze. Buried in the OBR report there will new estimates for what is expected to happen to wages and inflation until 2018. In terms of the economics, and politics, of living standards from now until the election this is key data. Given that the OBR’s forecast for growth in 2013 is very likely to be marked down (from rosy 2 per cent figure it set in March) the assumption for earnings may well also fall. Also, for those who want to get inside the numbers, be warned that the figures the OBR uses tend to be a bit optimistic as they are based on the mean rather than typical (ie median) wage.

Third, watch out for childcare. Given the size of the cuts that are coming down the path you might not expect any new areas of spending. But if there is to be any (outside of new capital investment – or more accurately a slowing down of the rate of infrastructure cuts) then childcare may be a beneficiary. Measures to help with childcare costs would support employment, speak to concerns over the cost of living, and be a nod to the Coalition’s woes with some women voters. In terms of what might actually get announced there is likely to have been a lively internal debate. On the one hand, there are those who favour introducing tax-relief – a slightly saloon bar approach - which will inevitably favour the better off (and which has been skewered by my colleague James Plunkett). Against this are those who would like to build on the 15 hours of free guaranteed pre-school childcare. This latter approach would be a step in the right direction and do something to reduce the shocking disincentives to work that many second earners face in low and middle income families. That said, the government may want to hold any such announcement back to the New Year when its Childcare Commission reports.

Fourth, there is the widely anticipated raid on pension tax relief for the affluent. The briefings are that around £1-1.5bn might be raised by lowering the annual limit on pension contributions from £50k to £30k. If so, be ready for a bit of a storm from the well-organised pensions lobby. But bear in mind that tax-relief is highly regressive and very expensive. It is indeed remarkable that the support for higher rate tax payers has been so protected given some of the cuts being made – some of the claims about these measure hammering "middle-earners" are very overdone.

Even so, there are better ways of cutting tax-relief for the affluent than restricting the annual limit: the lifetime allowance for tax privileged pension contributions should be cut instead. Bringing it down from £1.5m to £1m would raise up to £1.5bn (to put this perspective note that the typical size of annuity purchased is £25k). It’s also the case that those who say that this salami slicing of pension tax relief is destabilising for savers have a point: the government should work out once and for all how much it wants to raise from pension tax relief in this Parliament and then draw a line. And when it does this, it should bear in mind that it still needs to find the billions to pay for the final increase in the personal tax allowance to £10k before 2015.

Finally, care needs to be taken in adding up the scale of the future cuts. The briefing by the IFS on Thursday lunchtime will provide the definitive view on this. But if a figure is revealed for new cuts that need to be made in 2017/18 (because the structural deficit gets pushed back by another year) then bear in mind that this will be on top of a pile of other cuts – roughly £23bn - that have already been pencilled in for 2015/16 and 2016/2017 but are yet to be allocated. Osborne is accumulating an ever larger mountain of fiscal misery to be dished out between departments and welfare spending. For a guide to this unpleasant fiscal arithmetic you won’t do better than reading this from the IPPR and this from the SMF.

But also bear in mind, that if the OBR decided at some future date to change its assumptions about the amount of spare capacity in the economy, and therefore the size of the structural deficit, then all of these numbers would be greatly affected. In which case there would be probably be a need for another Autumn Statement.


George Osborne. Photograph: Getty Images

Gavin Kelly is a former Downing Street adviser to Gordon Brown and Tony Blair. He tweets @GavinJKelly1.

Photo: Getty Images
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The hidden crisis in the National Health Service

Hospitals are no longer safe places for their staff, warns Simon Danczuk.

It feels as though not a week can pass without the media warning of a fresh “crisis in the NHS”.

But while funding shortages and the impending junior doctor strike are rightly cause for concern, another major crisis is going largely unnoticed.

Figures show that 43 per cent of A&E staff have been physically assaulted at work. Every eight minutes there is some sort of violent incident in a UK hospital.

This is unacceptable, but unfortunately cases of violence against NHS workers seem to be on the increase while the government turns a blind eye to this problem of its own making.

Plotting a graph would show a startling correlation between insufficient NHS funding and the number of doctors and nurses being attacked. As NHS budgets reach breaking point, so too do many patients.

The issue, which will be highlighted in the documentary A&E: When Patients Attack, which airs tonight on Channel 5 at 10pm, is a national scandal.

Health experts suggest that the problem can be directly linked to longer waiting times and staff cutbacks, leading to growing frustration and tension in A&E and other departments. With winter fast approaching, and the notoriously busy festive season to come, incidents of violence look set to get worse. Nobody, least of all our overworked NHS doctors and nurses, should face the prospect of going to work to be attacked, spat at or insulted.

Based at the Queen Elizabeth in Birmingham, one of the country’s biggest hospitals, When Patients Attack follows a security team which uses uniformed guards and a bank of CCTV monitors to keep hospital staff safe.

The sight of a uniformed private security team in an NHS hospital is visually jarring, it would look more at home in a high-security prison than in a place of care and compassion. But the sad reality is, guards like this are a necessary part of the NHS under a Tory Government.

A&E centres across the UK, including the one in Rochdale, are being closed or consolidated creating extra journey times for patients and more pressure on those that remain.

But there is a gaping logical flaw here. NHS trusts are spending money, which should be on patient care, on employing security staff to deal with the fallout from cuts in care.

Seeing the level of physical, verbal and racial abuse that doctors and nurses have to endure makes When Patients Attack hard to watch at times. What is clear is that many of the patients featured are not lashing out for some malicious reason, they are vulnerable and bewildered people in need of care.

Many have learning difficulties or mental health problems, others are disorientated or in pain, there are those under the influence of drink or drugs and some just have nowhere else to go. A significant amount on the security team’s time seems to be spent convincing patients who have been discharged to leave the premises.

Here we see a less obvious example of how Conservative cuts are impacting on our NHS. Hospitals are always open and always welcoming. The duty of care means that no one is turned away. As a result, they are filling the void left by homelessness shelters and local government social services.

David Cameron has made much of the Government’s plan to put mental and physical health on an “equal footing”. But this will remain little more than empty rhetoric as long as those suffering from serious and complex mental health issues continue to seek help at A&E because of a lack of any alternative.

It is not just cuts to councils and the health service that have created this epidemic of NHS violence. In my constituency of Rochdale alone, Greater Manchester Police has been forced to withdraw 150 officers from the beat because of budget cuts. Business owners and members of the public have told me that Police response times have increased dramatically since 2010. It is important that violent incidents are diffused as quickly as possible and while an in-house security team is helpful, the additional support of trained Police officers is vital. Each additional minute that NHS staff have to wait for the Police increases the risk that a situation will escalate and become more serious.

Jeremy Hunt speaks of a seven-day-a-week NHS. But these grand plans ring hollow when we see the reality on the ground in the NHS today. This government cannot even guarantee that staff can work without the fear of physical harm. Our doctors and nurses are among the hardest working people in any community. The very least they can expect is to be able to care for us in a comfortable, supportive, and above all safe, environment.


Simon Danczuk is Labour MP for Rochdale