Mixed response to UK budget

The British Medical Association says the government has failed to address the funding crisis in the NHS with the budget, offering "little meaningful financial assistance" for the service which, it warns, is now "stretched to breaking point".

On the plus side, chancellor Philip Hammond said £2 billion would be streamed into social care over the next three years to help reduce the pressure on NHS services, with £1 billion available in 2017/18 to enable local authorities to start commissioning new care packages.

However, the NHS itself was only given £100 million for up to 100 trial GP triage projects in emergency departments in England, and just £325 million was allocated as capital for sustainability and transformation plans (STP), which is far under the £9.5 billion the union calculated would be needed to support these projects.

Hammond also announced that the government will publish in the Autumn a green paper setting out long-term solutions to the ongoing crisis in social care, and said new measures would be announced to identify and support authorities which are struggling. This, alongside greater collaborative working under the STPs, "will bring short and medium-term benefits," he said.

But BMA council chair Dr Mark Porter argued that the budget "does nothing to address the gaping hole in NHS finances. There is a £30 billion gap to fill and we should be increasing the UK’s health spending by at least £10.3 billion to match that of other leading European economies."

Also, he called on the government "to explain how they will fund and recruit GPs to work on site at hospitals when there already aren’t enough to meet the needs of the public," noting that "many are already working in practices with permanent vacancies which they are unable to fill, despite government promises at the last election to recruit 5,000 more doctors into general practice."

More beds and more doctors
"We need more beds and more doctors; this budget does not address these key issues. While an acknowledgement that implementing sustainability and transformation plans will require additional funding is welcome, the plans themselves aim to cut the overall number of beds available - a step in completely the wrong direction," said Dr Chris Moulton, vice president of the Royal College of Emergency Medicine.

"RCEM cautiously welcomes the extra £100m to be spent on A&E triage schemes in time for next winter, provided it is used appropriately. For some time, RCEM has called for co-location of urgent care services around major A&E departments and having primary care on site will undoubtedly benefit patients," he added.

Chris Ham, chief executive of The King’s Fund, also welcomed the extra funding for social care, but called on the government to "break the mould and deliver the radical reforms that are so badly needed".

"A starting point for this should be the work of the Barker Commission, which recommends a new settlement for health and social care and a single budget to put them both on a sustainable footing for the future. This will need to be funded by reforms to existing benefits paid to older people, increases in national insurance and changes to taxation," he argued.

"This winter the NHS has been buckling under the strain of meeting rising demand for services and maintaining standards of care. The Chancellor must address this in his autumn Budget or be honest with the public about the standards of care they can expect with the funding the NHS has been given."

"The extra funding will definitely help, but we await the details," commented NHS Confederation chief executive Niall Dickson. "We also welcome the announcement of a Green Paper on the long-term funding of social care - let us hope this time it results in action and not more words".

Pharma’s view
From pharma’s standpoint, the government said it would enhance the UK’s position as a world leader in science and innovation with £300 million to support the brightest and the best research talent, including support for 1,000 new PhD places and fellowships, focused on STEM subjects.

Also, £270 million is being streamed into Industrial Strategy Challenge Fund to keep the UK at the forefront of "disruptive technologies" like biotech, robotic systems and driverless vehicles, which, according to Steve Bates, chief executive of the BioIndustry Association, gives "a real opportunity to lead the world in new industries such as advanced therapy manufacturing - highly specialised production techniques that allow us to use cells and genes to treat a wide range of diseases from cancer to dementia".

"The Chancellor’s confirmation of funding to develop medicines manufacturing technologies and develop STEM skills is very welcome. However, what is missing from today’s Budget are measures to make the treatments and medicines we discover and develop in the UK, available to patients here," said Mike Thompson, chief executive of the Association of the British Pharmaceutical Industry.

"Right now, for every 100 European patients who can access new medicines in the first year of launch, on average just 15 UK patients receive the same. We are committed to work with government on the upcoming industrial strategy for Life Sciences, which is the best chance we have to reverse this," he noted.

Bates said the BIA would also liked to have seen an enhancement to the R&D tax credit scheme to allow companies to claim relief on investments in experimental and manufacturing equipment and the purchase of data for use in R&D.

"Medical data is as essential to modern drugs research as chemicals and clinical trials so it is a real missed opportunity not to address this discrepancy in the current system," he noted.