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UK Treasury resists calls for extra funding to boost NHS workforce

Britain’s Treasury is resisting calls for extra funding to address a critical shortage of doctors and nurses in England, insisting that money must come out of the health department’s existing budget.

In the Budget, Rishi Sunak, the chancellor, had been widely expected to announce a funding allocation for Health Education England, which is responsible for the recruitment and training of clinical staff, to help boost the workforce.

But to the frustration of health leaders, he promised only “hundreds of millions of pounds in additional funding over the [spending review] period to ensure a bigger and better trained NHS workforce”, without providing details.

England’s health service was short more than 100,000 staff — of whom about 40 per cent were nurses — when the coronavirus crisis hit. The Health Foundation, a charity, has estimated that 4,000 more doctors and 17,000 more nurses will be needed to clear the backlog of 5.7m patients whose care was disrupted by the pandemic.

The government announced in September that £30bn would be put into the health service over the next three years, mostly raised through a rise in national insurance contributions. Several people close to discussions say the Treasury is insisting that funding to boost the workforce must come out of this pot.

Health was one of the winners in the chancellor’s spending round on Wednesday, receiving an average rise of 3.8 per cent over the next four years. However, The Department of Health and Social Care and NHS England are resisting attempts to carve out cash for HEE from their own allocations as they struggle to make up ground lost during the pandemic, said several people close to the discussions.

Writing in the FT last weekend, former health secretary Jeremy Hunt underlined the importance of a strategic workforce plan, writing that it would be “an extraordinary waste of the additional £10bn a year funding the NHS and social care will receive if we do not train up enough doctors and nurses to make sure the money is actually used as intended”.

Government officials said the Treasury would work closely with DHSC and HEE to develop detailed workforce spending plans in due course. They pointed to the government’s commitment to ensure 50,000 more nurses by the end of the parliament and highlighted that English medical school places were at record levels following a funding boost.

Two people close to discussions said one proposal would entail HEE funding raised at the rate of inflation for the second half of the financial year and possibly the following year. But this would still fall far short of the three-year settlement that health leaders wanted.

Chris Hopson, chief executive of NHS Providers, said that since 2018 when Theresa May announced a long-term funding settlement that excluded funding for the workforce, “we have been saying that HEE needed a sensible, strategic three-year settlement. And we’ve all been told [by government officials] that ‘we absolutely understand that’”.

He added: “There is a huge level of frustration and disappointment that despite having banged that drum and been told it would be sorted, it hasn’t been.”

Hopson said that while frontline health leaders welcomed the extra revenue that was promised in September, and the announcement of additional capital investment at the weekend, “if we haven’t got the staff to do the work we’re going to be in real trouble”.

A clause in the health and social care bill now going through parliament requires the health secretary to set out the arrangements for workforce planning but Hopson argued this should be stronger to require the government to respond publicly to an independent assessment of the NHS’s workforce needs — and to make clear whether or not they will fund them.

“We need a much stronger commitment,” he said.

Additional reporting by George Parker

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