A year ago Jeremy Hunt was sitting on the back benches, and as chair of the health select committee was pushing an amendment to the Health and Social Care Bill – to enforce assessment of NHS, social care and public health staffing needs. He failed but helped to strengthen the case for a properly funded workforce plan and now as chancellor has the chance to deliver it. Has he? No, not yet.
As health secretary (2012-18), Hunt was part of the coalition austerity government that consistently neglected NHS workforce planning, helping to create the crisis that is now producing delays in treatment, suffering and unnecessary deaths.
Now, despite running the treasury Jeremy Hunt still hasn’t removed his department’s long standing resistance to backing a funded workforce strategy. Given his personal stance on the issue and the loud consensus for action, it was a glaring omission from his recent financial statement, but he has turned up the dial on his pledge
“the Department of Health and Social Care and the NHS will publish an independently-verified plan for the number of doctors, nurses and other professionals we will need in five, 10 and 15 years’ time, taking full account of the need for better retention and productivity improvements.”
Although the announcement was welcomed by commentators and NHS England, pledges, reviews and unfunded strategies have been seen and heard over the last four years, the cash for implementation remains the missing element.
As The Health Foundation noted:
“The Chancellor’s commitment to publish long term workforce projections is very welcome but doesn’t yet come with any additional funding or plan to expand the workforce.”
Pressure from organisations within the NHS for a funded workforce plan has been building, most recently a coalition of over 100 health and care organisations, including the Royal College of Physicians (RCP), signed a letter to the Chancellor in support of publishing the NHS long-term workforce plan in full, including assessments of how many staff will be needed to keep pace with demand.
Commenting on the plan announcement, the RCP noted:
“It is vital that the workforce plan, when it is published next year, comes with a clear commitment to provide the funding necessary to make this happen.”
There certainly is nothing spare going in the current budget for the NHS for the workforce plan. The Autumn statement included an extra £3.3bn for the NHS in each of the next two years, but experts have warned that this amount is probably only half of what is needed to keep the health service going.
Only last month NHS England forecast a £7bn shortfall in its funding next year, a black hole which it warned could not be filled by increased efficiency measures alone. As a result, GP services, cancer care and mental health treatment may be some of the areas that will face cuts.
NHSE is now committed to submitting projections of long-term workforce requirements to the Department of Health and Social Care by April 2023, DHSC officials, however, have not committed to a timeline for publishing the projections, or that they will be published in full.
At whatever date the workforce plan is published, it will remain just a plan unless funds are committed to it to increase training and improve retention.
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