New money welcome but key services left hanging - Nuffield Trust response to Budget

Confirmation of £20 billion for the NHS is welcome, however, social care only receives a short-term fix and questions remain around the budgets for hospital buildings, IT investments, training or public health.

Press release

Published: 29/10/2018

Reacting to the 2018 Budget, Nuffield Trust Chief Economist John Appleby said:

“Confirmation that the Government will indeed give £20 billion more to NHS England by 2023 will bring a measure of relief to the hard-pressed service. But we must not get carried away.

“After a financial squeeze of many years, much of this new money will be needed just to get the basics back on track – keeping up with rising need, addressing sliding waiting times and fixing the worrying backlog of buildings needing repair. Our calculations show that after meeting the commitments already made to patients, only £500 million will be free next year for any improvements – less than a tenth of the headline increase.

“Meanwhile, the financial fate of the vital services on which the NHS relies on was once again left hanging today. While more money going into social care will be welcome, it is another short term fix to a system nobody seriously disputes is fundamentally broken. Troublingly, we heard no guarantees today about the budgets for hospital buildings, IT investments, training or public health. We did hear a guarantee of no new PFI deals – but let’s be realistic, there were none on the horizon anyway.

“The uncertainty of Brexit also hangs in the air. This may bring further demands on the health service’s limited room for manoeuvre. The Government believe that a no deal exit would put an £80bn long-term annual hole in the public finances which pay for the NHS. If that happened, austerity might 'come to an end', as the Chancellor said, only to start all over again.”

Notes to editors

  1. See our analysis of the new financial settlement and how much will be available for health service improvements here   
  2. The Government’s assessment of the impact of a no deal Brexit concludes it would result in an £81bn hole in the public finances by 2033/34
  3. The Nuffield Trust is an independent health think tank. We aim to improve the quality of health care in the UK by providing evidence-based research and policy analysis and informing and generating debate.
  4. For any questions or to arrange an interview, please contact /; 0207 462 0555 / 0207 462 0538.