From a physiotherapy perspective, there is much to welcome in the budget. It marks a pivotal moment for public spending, particularly in the health and social care sectors.
As we look ahead to 2024-25 and beyond, the commitment to investing an additional £22.6 billion in resource spending for the Department of Health and Social Care in 2025-26 is not only encouraging but essential for the future of our NHS.
This substantial investment is set to empower the NHS in England to deliver an impressive 40,000 additional elective appointments each week. This commitment reflects the government’s determination to ensure that patients can expect to wait no longer than 18 weeks from referral to consultant-led treatment. It’s a promise that will significantly enhance patient care and streamline the healthcare experience for many.
However, it will take sustained above inflation spending over future years to get the NHS back on an even keel and to allow the scale of transformation envisaged by the government. Extra money for the NHS in England also means more money for Scotland, Wales and Northern Ireland, although it will be for ministers in those countries to decide how it is spent.
Capital spending
It was positive to see a commitment to more capital spending for the NHS estate and scanners with over 1.25 million additional diagnostic tests, and new beds across the NHS estate, and £1 billion to address the backlog of critical maintenance, repairs, and upgrades. These are concrete steps towards a more efficient and effective healthcare system.
The poor condition of many buildings has been a long-standing concern for CSP members on health and safety grounds. Lack of access to rehab spaces in both acute and community settings - and specialist facilities such as hydrotherapy pools - limits the quality-of-care physios and physio support workers can offer patients. How much of the funding will be targeted at a few major projects aren’t clear as I write, and where improving rehab facilities sits in local estate priorities could well remain a challenge.
It wasn’t until the second term of Labour’s last period of office that they made significant impact on the NHS. The fact they are starting with the NHS as a focus this time round is encouraging but we all know more will be needed, not least to pump prime changes in areas like community rehab which will reduce taxpayer costs in the longer term. Investing up front in quality, person centred, multi condition, neighbourhood rehab services could save the DWP a minimum £2billion.
Welfare budget
Savings on the welfare budget are, however, controversial. The CSP backs active support for people to get into work, including through rehab and targeted physiotherapy support where appropriate. We see appropriate professional assessment based on potential and ability as key to this, and this is a role physios have been providing for many years. However there has been some disquiet over savings linked to the work capability assessment being in the budget. Labour have indicated that they plan to refocus assessment, but the budget does not provide any further details on this at this stage.
Tax changes
The decision to raise more through employers’ national insurance and the minimum wage increase will not be welcomed by some business owning physios who employ staff. But, given the commitments both main parties made not to increasing employee national insurance or income tax, it inevitably meant businesses would have to contribute more to address the fiscal gap. The minimum wage increase will, however, increase bottom band pay within the NHS.
Increases in duty on alcohol, tobacco and sugary drinks are welcome. Whilst no doubt motivated by the need to raise revenue, they will have a positive health impact. There is evidence that increasing the cost of alcohol reduces use and positively impacts the nation’s health.
Other areas where physio have an interest were also covered in the budget. Defence received an extra £2.9 billion including funding for pay awards. An additional £600 million was allocated to social care. It is clear that the government has prioritised health and economic infrastructure at the start of their administration.
Overall, this budget is a step in the right direction for the physiotherapy profession. However, the government faces significant challenges ahead. To fulfil their ambitious NHS rebuilding plans, consistent higher spending over the next four to five years -and potentially beyond - is essential.
As we move forward, the future of physiotherapy looks promising, but continued advocacy and investment will be critical to ensuring we meet the needs of our patients and the healthcare system.
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