CoP response to the Comprehensive Spending Review

Comprehensive Spending Review
This afternoon the Chancellor announced his Comprehensive Spending Review (CSR) for one year. The CSR will cover the period until autumn 2021, which is significantly shorter than the standard multi-year length of a CSR.
The Government states that this will allow them to set budgets in line with the demands of the COVID-19 pandemic for this year and defer further spending decisions until next year. See the Chancellor's full Spending review 2020 speech.

The news of the £3bn for the NHS in England was released at the weekend. This extra £3bn will be allocated with £500m going towards mental health services, £1bn towards tackling NHS waiting times and the backlog of care that has built-up within the health system, and £1.5bn for general support to relieve COVID-19 related pressure across the health system.

The Chancellor said there would be extra funding for the NHS, including £280bn to get the UK through COVID-19, along with £18bn for testing, PPE and vaccines. He announced that there will be a pay increase for one million doctors, nurses and others. There were no details on the size of the increase or the who the Chancellor refers to as 'others'. The NHS employs approximately 1.5 million people, it is not known who the 500,000 who will not receive a pay rise are. The NHS is one team and we all play a part and no groups should be favoured above others.

We welcome the extra £1bn for social care; however, this will be distributed between adult social care and children’s social care services, and will no doubt just scrape the surface of the true need.

Suppressing public sector pay at a time of economic uncertainty is unhelpful. The economy needs support now and increasing public sector pay would put money straight into local economies in every corner of the country.

We need to help make working in the NHS a more attractive option for people. Higher pay will help do that – attracting new staff, but just as importantly retaining existing NHS staff. All those people will be needed not just now, as we tackle the pandemic, but in the months and years to come as the NHS undertakes the long job of recovering from the impact of the pandemic. An early and significant pay rise would also be a way of showing our healthcare staff the real appreciation we have for them and what they have done to tackle the greatest challenge to face the NHS in its 72-year history. Applause can feed the soul, but they need a pay rise to make it easier for them to feed their families too.

Obviously the extra £3bn will be welcomed to help reduce the build-up caused by the pandemic. For the NHS and social care to function effectively they have to be viewed as one system. We need to see similar investment in Community health services to ensure the preventative interventions can take place. Whilst investment in Acute services is obviously needed, if the resource is Acute heavy, the issues that can be tackled downstream will not be prevented.

The College wish to see increased investment in the NHS workforce, with a clear workforce plan that increases staff numbers in line with patient need. We want to see the People Plan fully resourced to ensure this can be achieved. Whilst we welcomed the partial reintroduction of bursaries in England, we would have liked to have seen the Government go further and bring in a fully-funded bursary that links to guaranteed employment in the NHS on graduation. This is vital to ensure that we have a diverse workforce that reflects the population. Tertiary education should not be based upon income. Broadening access, particularly into healthcare-related higher education benefits wider society. The fees for higher education in England outweigh any other country in the world.

We look forward to seeing the details of this CSR specifically around the NHS pay and are ready with the other NHS trade unions to enter into meaningful dialogue to ensure a fair pay outcome. This CSR comes at a time when the Treasury has borrowed £394bn, the highest recorded borrowing in peacetime, yet at a time when the interest rates on government borrowing are negative.

More details can be found here.

Steve Jamieson
Chief Executive and General Secretary 
The College of Podiatry

25 November 2020