Scary…

News and Comment from Roy Lilley.

Packet of Hobnobs and a bucket of builder's.  Seat booked on the sofa; it's budget time.  Budgets used to be in the Spring, now they are in the Autumn.  How did that happened?  Global warming, maybe?

I have to be honest, I hate watching Westminister at work.  The behaviour is cringe-making, embarrassing.  I'd hoped the influx of younger, many female members, might have had a sobering effect.  No, it's getting worse.  The youngsters have caught the contagion of parliamentary hooliganism.

I put my feet up and settled in.  Chancellor Hammond was amusing and reassuring.  Put a spin and gloss on the nation's affairs.  Early passages about optimism and technology and innovation and stuff, had me comfy.

But not for long... the facts are; the economy is no where near as healthy as Hammond would have us believe.  The Office of Budget Responsibly has down-graded our growth prospects and Brexit... well, so far it's cost us £700m and will cost a further £3bn, perhaps more.  

The OBR forecast for national, annual productivity growth of 0.2% gets nowhere near the 1.7% the NHS is delivering.  Make sure you remember that.

Chancellor Osborne said we would be borrowing £10bn by 2019.  Hammond will be borrowing £35bn. 

For the foreseeable, we are stuck in the slow-lane.  Has Hammond given up on balancing the books?  It looks to me, yes.  The deficit is about the same level as pre 2010.  The bigger problem; national debt.  There is a subtle change in metrics.

The health service?  Sorry, it doesn't add up to much.  

There's £350m for the winter pressures.  Strangely the same amount once advertised on the side of a bus!  Not wishing to be churlish but at this late stage, what can you spend the money on that will not be inflationary.  Agency staff, mainly.  Nothing for social care, so NHS buying discharge care-packages, probably.

Next year, £1.6bn (non-recurring) revenue funding.  The big brains like Anita Charlesworth, where calling for £4bn and Simon Stevens did not demur.  

Any time soon we'll have to answer the question; 'What shall we stop doing?'

There's an extra £3.5bn for capital spending over the next three years, more to be raised by a fire-sale of land and assets.  

£2.6bn allocated through sustainability and transformation partnerships. More detail here.

If you come to work in an electric car, your employer can get cash for a charging point and you wont be taxed as a benefit in kind.  

If you come by train and you are 24-30, you can get a rail card, for cheaper travel but only if you can be in work after 10am.

If you run pharmacy - the change in biz-rates will be welcome.

If you'd like an apprenticeship for junior, there's money for that and if you can manage it, first-time buy a house, up to £300k, with no stamp duty.

If you supply the NHS and your product is wrapped in plastic (and what isn't), you'd better find an alternative.  You're gonna be taxed and don't expect to pass it on to NHS procurement.

The important bit; pay.  

In fairness, only the NHS singled out, not teachers, or prison officers and the rest.  The pay review bodies will report and their recommendations are promised to be fully funded but... as predicted, it looks like unpicking Agenda for Change... the present arrangements do not allow for singling out one staff group.  The Tinkerman is already in talks. 

What are we to make of this?  The NHS has done better than any other public service.

The Chancellor has little head-room and has put what money he has now, up-front.  It's a bigger gamble than is first apparent.  If the economy continues to slide and Brexit costs more than predicted, we are in a mess.  

The NHS has done much better than any other public service and the sub-text; now get on with it.

Sure, we can continue to moan but moaning doesn't make us money.  We can debate the politics of every penny but it won't add up to a pound.

We've pulled out the last shilling from down the back of the sofa.  Now we're looking at the world from behind the sofa.  We're on our own...  

It's scary.

-----------------------------------   

 Contact Roy - please use this e-address

roy.lilley@nhsmanagers.net 

Know something I don't - email me in confidence.

Leaving the NHS, changing jobs - you don't have to say goodbye to us! You can update your Email Address from the link you'll find right at the bottom of the page, and we'll keep mailing.

----------
Disclaimer