The Autumn Statement tomorrow (22 November) may be this government’s final opportunity to change course before the next election, and to provide the funding that the NHS desperately needs.
There is no way of sugarcoating it: the NHS is in a dire state, and winter pressures are mounting. The new Health Secretary, Victoria Atkins, faces a moment that may define her tenure in the job. At the top of her in-tray must be securing the funding that the NHS and social care need, both in the short and long term.
With five health secretaries in just over two years, a vision for the NHS with the funding to match has been dangerously abandoned amid the melodrama of Westminster. The Treasury must dig deep into the national coffers to find funding for the health service, instead of eyeing up tax breaks for the wealthiest.
It’s clear the NHS is in a perilous state. Just today the Nuffield Trust revealed analysis highlighting that the NHS is on track to have a near £1.7bn shortfall in its budget this year – and unless the Chancellor commits to additional funding in the Autumn Statement, waiting times and other improvements to NHS services will suffer.
Leading nurses tell me they fear the months ahead more than any previous winter. Patients are already being treated in hospital corridors by nursing staff who are stretched too thin – sometimes caring for ten, 15 or more patients at a time. It’s clear the NHS needs an urgent cash injection.
Things also look difficult in the long term. It’s been five months since the government published its long-awaited NHS Long Term Workforce Plan. That was an important step, although there is not sufficient detail about how these ambitious plans will be funded. We want to work constructively with the NHS and government to address what is missing, especially on plans to improve workforce recruitment and retention.
Central to the workforce plan is growth in the nursing workforce, but there are still tens of thousands of vacancies across the NHS in England. To recruit more UK nursing students, the government must fund more university places and remove the burden of student debt and tuition fees from prospective nurses. Nursing students are currently, on average, accruing £50,000 of student debt, and typically struggling with the costs of accessing their clinical placements. On top of the rising costs of living, many are unable to complete their studies as a result.
To retain nursing staff once they are in the profession, fair pay is crucial. This is a key part of ensuring people feel valued and continue in their roles.
Without taking the necessary measures to grow the workforce, nursing staff will keep suffering under immense pressure, and patient demand will continue to outstrip the modest growth of the NHS workforce. Since 2019, the patient waiting list for elective care has grown more than four times as fast as the number of nurses. Unless the government changes course, it will bake in a permanent decline in the level of care patients can expect when they encounter the health and care service.
Nursing staff will be dismayed if Jeremy Hunt uses the Autumn Statement to prioritise tax cuts for the few, over the health and well-being of the many. If the Chancellor is to pull a rabbit out of the hat this week, it must be funding to help the NHS get through this winter, and the long-term funding it needs to grow its workforce so it isn’t constantly fighting fires.
Simply put, nursing staff don’t want to see the government playing politics with our health service. They want to see genuine commitment to their profession and their patients, and solutions that address the fundamental issues. It is the only way to fix the problems in the NHS.